Individual
MRS. MARINA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD CLC
Contact information
Practice address
30 N GOULD ST STE N, SHERIDAN, WY 82801-6317
(720) 680-2940
Mailing address
30 N GOULD ST STE N, SHERIDAN, WY 82801-6317
(720) 680-2940
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
009597
NY
133V00000X
Registered Dietitian
Primary
009597
NY
174N00000X
Lactation Consultant (Non-RN)
282242
—
Other
Enumeration date
05/16/2018
Last updated
08/22/2025
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