Individual
LATOYA DEMETRIST LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
12101 WOODCREST EXECUTIVE DR, SUITE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
Mailing address
12101 WOODCREST EXECUTIVE DR, SUITE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-107524
AL
Other
Enumeration date
11/10/2010
Last updated
05/13/2015
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