Individual
MICHELLE L LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 PROSPECT AVE FL 6, SYRACUSE, NY 13203-1807
(315) 448-5491
(315) 423-6823
Mailing address
301 PROSPECT AVE FL 6, SYRACUSE, NY 13203-1807
(315) 448-5491
(315) 423-6823
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
344578
NY
Other
Enumeration date
06/21/2019
Last updated
06/21/2019
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