Individual
PATRICIA J LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 MEDICAL CENTER DRIVE, SLIDELL, LA 70461-5520
(985) 626-7631
Mailing address
100 MEDICAL CENTER DRIVE, SLIDELL, LA 70461-5520
(985) 649-7070
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041120
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041120
ADVANCED PRACTICE
LA
05
—
04526866
—
MS
05
—
1910210
—
LA
01
—
41120
RN LICENSE
LA
Enumeration date
06/04/2006
Last updated
01/05/2011
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