Lane, Mary L

Lane, Mary L is an individual health care provider with primary practice located at 10762 Se Us Highway 441 , Belleview FL 34420-3805. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Lane, Mary L can be contacted via phone (352) 347-5225.

Contact Information

Primary practice address
10762 Se Us Highway 441 Belleview FL 34420-3805
Phone: (352) 347-5225
Fax: (352) 347-1073
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP3083192 Florida

Profile Details

NPI number 1568614303
LBN Legal business name Lane, Mary L
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2008
Last updated Nov 15th, 2012 - about 12 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 1568614303 NPPES
Florida Other Y00N4 BSBC FL
Florida MEDICAID 0008590-00 BSBC FL

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