Individual provider · Type 1 NPI

Jordan Lane

Medical Physician Assistant · Mesa, AZ

NPI number 1447091475 Active

Practice location

5850 E Still Cir
Mesa, AZ 85206-3618

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA00963 (MS)

Medical Physician Assistant: Definition to come...

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About NPI 1447091475

Jordan Lane's National Provider Identifier is 1447091475, issued on Jun 4, 2024. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Mesa, AZ. The record was last updated on Aug 27, 2026.