Individual
MRS. SHEKETA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8188 US HIGHWAY 51 N, MILLINGTON, TN 38053-1750
(901) 614-4455
Mailing address
8358 CHAMPIONSHIP DR APT 101, MEMPHIS, TN 38125-0783
(901) 338-9215
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
50.005228RX
OH
363A00000X
Physician Assistant
Primary
3468
TN
Other
Enumeration date
10/05/2017
Last updated
02/23/2018
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