Individual
JESSICA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
650 KIMMELL RD, VINCENNES, IN 47591-6341
(812) 886-0006
Mailing address
650 KIMMELL RD, VINCENNES, IN 47591-6341
(812) 886-0006
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26022891A
IN
Other
Enumeration date
08/29/2019
Last updated
02/29/2024
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