Healthcare Provider Details

I. General information

NPI: 1831006170
Provider Name (Legal Business Name): MORGAN RAE LANE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2076 COLLINS RD
COLLINS OH
44826-9732
US

IV. Provider business mailing address

2076 COLLINS RD
COLLINS OH
44826-9732
US

V. Phone/Fax

Practice location:
  • Phone: 419-306-0579
  • Fax:
Mailing address:
  • Phone: 419-306-0579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberAPRN.CNP.0043000
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: