Individual provider · Type 1 NPI

Tabitha Marie Lane, PA

Physician Assistant · Canon City, CO

NPI number 1356650360 Active

Practice location

715 S 9th St
Canon City, CO 81212-4911

Call (719) 269-8820 Map

Mailing address

402 Star Ranch Rd
Canon City, CO 81212-9831

Other practice locations

1008 Minnequa Ave, Pueblo, CO 81004-3733 · (719) 776-8040
1090 Arnold Dr, Little Rock Afb, AR 72099-4933 · (501) 987-2932

Specialties and licenses

Taxonomy	Code	License
Medical Physician Assistant	363AM0700X	PA.0003062 (CO)
Physician Assistant	363A00000X	9120043 (FL)
Physician Assistant Primary	363A00000X	PA.0003062 (CO)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1356650360

Tabitha Marie Lane, PA's National Provider Identifier is 1356650360, issued on Sep 26, 2010. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Canon City, CO. The record was last updated on May 11, 2026.