Individual
ASHLEY ELIZABETH LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 202-0450
Mailing address
4530 PRUNTY AVE, JACKSONVILLE, FL 32205-7149
(904) 347-4128
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9410275
FL
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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