Individual
MS. PATRICIA BRIDGET LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, LD/N, LD
Contact information
Practice address
2225 SE GASLIGHT ST, PORT ST LUCIE, FL 34952-7332
(954) 592-2502
Mailing address
2225 SE GASLIGHT ST, PORT ST LUCIE, FL 34952-7332
(954) 592-2502
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86015440
—
133V00000X
Registered Dietitian
LD-2023-048
NM
133V00000X
Registered Dietitian
ND10141
FL
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
DT86915
TX
Other
Enumeration date
02/02/2024
Last updated
08/20/2024
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