Healthcare Provider Details

I. General information

NPI: 1659475911
Provider Name (Legal Business Name): AMY MICHELLE LANE APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY TAYLOR APRN

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19409 PLANTATION RD, STE 4
REHOBOTH BEACH DE
19971-4413
US

IV. Provider business mailing address

19409 PLANTATION RD UNIT 4
REHOBOTH BEACH DE
19971-4493
US

V. Phone/Fax

Practice location:
  • Phone: 302-224-1400
  • Fax: 302-224-1402
Mailing address:
  • Phone: 302-224-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberL8-0010941
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number002158
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number002158
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number002158
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: