Lane, Maryellen C

Lane, Maryellen C is an individual health care provider with primary practice located at 155 Memorial Dr , Pinehurst NC 28374-8710. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Lane, Maryellen C can be contacted via phone (910) 715-2085.

Contact Information

Primary practice address
155 Memorial Dr Pinehurst NC 28374-8710
Fax: (910) 715-1237
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 123435 North Carolina

Profile Details

NPI number 1578502134
LBN Legal business name Lane, Maryellen C
Credentials NNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated May 14th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578502134 NPPES
North Carolina MEDICAID 7000353

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