Individual
IVA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2198 US 31 S, MANISTEE, MI 49660-9618
(231) 655-3146
Mailing address
2198 US 31 S, MANISTEE, MI 49660-9618
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704343001
MI
Other
Enumeration date
09/29/2025
Last updated
09/29/2025
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