Individual
MRS. JESSICA BARNES LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RNFA
Contact information
Practice address
111 LONGWOOD AVE, ROCKLEDGE, FL 32955-2827
(321) 636-2211
Mailing address
520 MONROE AVE APT 10, CAPE CANAVERAL, FL 32920-2259
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9248011
FL
163WR0006X
Registered Nurse First Assistant
Primary
9248011
FL
Other
Enumeration date
04/12/2018
Last updated
06/16/2018
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