Individual
CORNELIA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
201 E GROVER ST, SHELBY, NC 28150-3917
(980) 487-3678
(980) 487-3294
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11040095
FL
363LA2100X
Acute Care Nurse Practitioner
5007296
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982009049
—
NC
05
—
QNP283
—
SC
Enumeration date
10/30/2014
Last updated
04/08/2026
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