Individual
JASON LAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 606-6137
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP123219
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
692685
TX
Other
Enumeration date
06/06/2013
Last updated
02/16/2024
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