Individual
MRS. JILL DENISE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2863 ALT 19, PALM HARBOR, FL 34683-1926
(727) 781-5652
(727) 781-3792
Mailing address
2863 ALT 19, PALM HARBOR, FL 34683-1926
(727) 781-5652
(727) 781-3792
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN1218601
FL
Other
Enumeration date
09/11/2008
Last updated
09/11/2008
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