Individual
LAURIE GENE LANE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PC-C
Contact information
Practice address
308 MAIN ST, OLATHE, CO 81425
(970) 323-6141
(970) 249-8421
Mailing address
PO BOX 529, OLATHE, CO 81425-0529
(970) 323-6141
(970) 249-8421
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
142
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07142003
—
CO
Enumeration date
12/30/2005
Last updated
07/08/2007
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