Lane, Brenda

Lane, Brenda is an individual health care provider with primary practice located at 2359 N Triphammer Rd , Ithaca NY 14850-1059. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Lane, Brenda can be contacted via phone (607) 257-1705.

Contact Information

Primary practice address
2359 N Triphammer Rd Ithaca NY 14850-1059
Phone: (607) 257-1705
Fax: (607) 257-3163
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 332286 New York

Profile Details

NPI number 1417910209
LBN Legal business name Lane, Brenda
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 11th, 2006
Last updated Apr 10th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417910209 NPPES
New York MEDICAID 02393520
New York Other BB7606

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