Individual
SANDRA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5974 FASHION POINT DR STE 110, OGDEN, UT 84403-4712
(801) 917-2270
(385) 831-2987
Mailing address
5974 FASHION POINT DR STE 110, OGDEN, UT 84403-4712
(801) 917-2270
(385) 831-2987
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
98524853102
UT
363L00000X
Nurse Practitioner
Primary
3852485-4405
UT
Other
Enumeration date
11/01/2020
Last updated
09/22/2021
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