Individual
MRS. JESSICA D LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1500 W ELK AVE, ELIZABETHTON, TN 37643-2654
(423) 543-2584
(423) 722-2060
Mailing address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 431-0509
(423) 722-2060
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APN24503
TN
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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