Individual
AMY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9E DR OSMAN BABSON ROAD, GLOUCESTER, MA 01930-1812
(978) 890-7373
(978) 890-7372
Mailing address
9E DR OSMAN BABSON ROAD, GLOUCESTER, MA 01930-1812
(978) 890-7373
(978) 890-7372
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7689
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110163493A
—
MA
Enumeration date
07/16/2020
Last updated
04/12/2023
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