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Individual

MR. THOMAS JASON LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC, PMHNP-BC

Contact information

Practice address
4011 WESTCHASE BLVD STE 225, RALEIGH, NC 27607-3978
(919) 828-9937
(919) 828-4287
Mailing address
4011 WESTCHASE BLVD STE 225, RALEIGH, NC 27607-3978
(919) 828-9937
(919) 828-4287

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
005002027
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
005002027
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7006352
NC
Enumeration date
08/21/2006
Last updated
01/17/2024
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