Individual provider · Type 1 NPI

Jeremy Lane Jr., P.A.-C.

Surgical Physician Assistant · St. Louis Park, MN

NPI number 1144205220 Active

Practice location

3931 Louisiana Ave S
St. Louis Park, MN 55426-5000

Call (952) 993-3230 Map

Fax (952) 993-1748

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X9937 (MN)

Surgical Physician Assistant: Definition to come...

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About NPI 1144205220

Jeremy Lane Jr., P.A.-C.'s National Provider Identifier is 1144205220, issued on Dec 12, 2005. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in St. Louis Park, MN. The record was last updated on Mar 29, 2019.