Individual provider · Type 1 NPI
Nicole Renea Lane, NP ADULT GERONTOLOGY
Nurse Practitioner · St. Louis, MO
Practice location
12401 Olive Blvd
St. Louis, MO 63141-5443
Mailing address
474 Brookhaven Ct
O Fallon, MO 63368-9634
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 77185 (KS) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1942744222
Nicole Renea Lane, NP ADULT GERONTOLOGY's National Provider Identifier is 1942744222, issued on Dec 6, 2016. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in St. Louis, MO. The record was last updated on Sep 28, 2021.