Individual
MAKENZIE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4553 WATKINS ST, PACE, FL 32571
(850) 800-2772
Mailing address
4553 WATKINS ST, PACE, FL 32571-2511
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN9491838
FL
Other
Enumeration date
12/14/2021
Last updated
12/14/2021
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