Healthcare Provider Details

I. General information

NPI: 1417878687
Provider Name (Legal Business Name): BEKINA LANE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 FOX RUN CIR
PELL CITY AL
35125-9336
US

IV. Provider business mailing address

290 FOX RUN CIR
PELL CITY AL
35125-9336
US

V. Phone/Fax

Practice location:
  • Phone: 256-493-4814
  • Fax:
Mailing address:
  • Phone: 256-493-4814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6869C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: