Individual provider · Type 1 NPI

Lane Tupa

Student in an Organized Health Care Education/Training Program · Jackson, TN

NPI number 1245060367 Active

Practice location

700 W Forest Ave Fl 5
Jackson, TN 38301-3937

Call (731) 541-3755 Map

Mailing address

12100 Rainwood Rd Apt 38
Little Rock, AR 72212-3936

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1245060367

Lane Tupa's National Provider Identifier is 1245060367, issued on Aug 5, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Jackson, TN. The record was last updated on Apr 9, 2025.