Individual
JENNIFER LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7529 MEDICAL DR, HUDSON, FL 34667-6502
(727) 862-6524
Mailing address
611 FATHOM CT, TAMPA, FL 33602-5796
(813) 477-9885
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9294413
FL
Other
Enumeration date
04/09/2016
Last updated
04/09/2016
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