Individual
MCTISA MICHELLE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2817 ROCK MERRITT AVE STOP A, FORT BRAGG, NC 28310-8862
(910) 907-8707
(910) 907-6069
Mailing address
2817 ROCK MERRITT AVE STOP A, FORT BRAGG, NC 28310-8862
(910) 907-8707
(910) 907-6069
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5005342
NC
Other
Enumeration date
10/03/2011
Last updated
06/09/2025
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