Individual
TERESA KAY LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, CPNP
Contact information
Practice address
12 EASTBROOK BND, PEACHTREE CITY, GA 30269-1530
(770) 487-3330
(770) 487-7736
Mailing address
12 EASTBROOK BND, PEACHTREE CITY, GA 30269-1530
(770) 487-3330
(770) 487-7736
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN163766
GA
Other
Enumeration date
12/20/2006
Last updated
03/06/2013
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