=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427814375
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANN E LANE ARNP INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2024
-----------------------------------------------------
Last Update Date | 02/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 216 SW HEARTSONG CT
-----------------------------------------------------
City | HIGH SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32643-1245
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-443-2148
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 216 SW HEARTSONG CT
-----------------------------------------------------
City | HIGH SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32643-1245
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-443-2148
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. ANN ELIZABETH LANE
-----------------------------------------------------
Credential | ARNP
-----------------------------------------------------
Telephone | 352-443-2148
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------