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Individual

LANE A ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSN RN PPCNP-BC CPN

Contact information

Practice address
4420 KIMBELL DR, WICHITA FALLS, TX 76302-3006
(940) 696-1600
(940) 696-1665
Mailing address
200 MLK JR BLVD, WICHITA FALLS, TX 76301-1152
(940) 696-1600
(940) 696-1665

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP139415
TX

Other

Enumeration date
10/23/2018
Last updated
10/23/2018
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