Individual
TADD LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
(503) 343-6195
Mailing address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
(503) 343-6195
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22660
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6106
—
SC
Enumeration date
05/30/2019
Last updated
04/27/2025
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