Individual provider · Type 1 NPI
Shannon Lane, NP
Gerontology Nurse Practitioner · Appleton, WI
NPI number
1386428811
Active
Practice location
2807 N Ballard Rd
Appleton, WI 54911-8701
Mailing address
108 Lamine Ln
Combined Locks, WI 54113-1100
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 13535-33 (WI) |
Gerontology Nurse Practitioner: Definition to come...
Other gerontology nurse practitioner providers in Appleton
About NPI 1386428811
Shannon Lane, NP's National Provider Identifier is 1386428811, issued on Aug 24, 2023. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Appleton, WI. The record was last updated on Feb 24, 2026.