Lane, Kristopher Olen

Lane, Kristopher Olen is an individual health care provider with primary practice located at 122 Latimer St , Latta SC 29565-1828. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Lane, Kristopher Olen can be contacted via phone (843) 627-6252.

Contact Information

Primary practice address
122 Latimer St Latta SC 29565-1828
Phone: (843) 627-6252
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 20909 South Carolina

Profile Details

NPI number 1306378856
LBN Legal business name Lane, Kristopher Olen
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2017
Last updated Apr 27th, 2023 - about 3 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 1306378856 NPPES
South Carolina Other SCA484 MEDICARE
South Carolina MEDICAID NP4553 MEDICARE

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