Individual provider · Type 1 NPI

Jessica Lynn Lane, CPNP-PC

Pediatric Nurse Practitioner · St. Clair Shores, MI

NPI number 1922767284 Active

Practice location

20225 E 9 Mile Rd
St. Clair Shores, MI 48080-1700

Specialties and licenses

TaxonomyCodeLicense
Pediatric Registered Nurse 163WP0200X4704342324 (MI)
Pediatric Nurse Practitioner Primary 363LP0200X4704342324 (MI)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1922767284

Jessica Lynn Lane, CPNP-PC's National Provider Identifier is 1922767284, issued on Dec 14, 2021. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in St. Clair Shores, MI. The record was last updated on Oct 26, 2022.