Lane, Kim Rae

Lane, Kim Rae is an sole proprietor health care provider with primary practice located at 630 15Th Ave Suite 200, Longmont CO 80501-2700. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Lane, Kim Rae can be contacted via phone (303) 776-5820.

Contact Information

Primary practice address
630 15Th Ave Suite 200 Longmont CO 80501-2700
Fax: (303) 776-3302
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 36341 Colorado

Profile Details

NPI number 1477548188
LBN Legal business name Lane, Kim Rae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 19th, 2005
Last updated Jul 8th, 2010 - about 16 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 1477548188 NPPES
Colorado MEDICAID 77633024

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