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NPI Code Detail

MEDICARE: LANE JHASE WALLER

MEDICARE: LANE JHASE WALLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1831049261
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANE JHASE WALLER
Provider Business Mailing Address
First Line : 720 SAINT JOHN ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70501-6706
Country : US
Telephone Number : 337-237-2090
Fax Number :
Provider Business Practice Location Address
First Line : 720 SAINT JOHN ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70501-6706
Country : US
Telephone Number : 337-237-2090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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Directions to “ LANE JHASE WALLER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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