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General NPI Number Information
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NPI Number | 1457852790
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Entity Type | Organization
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Legal Business Name | LANE WOMEN'S HEALTH, LLC
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Dates
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Enumeration Date | 02/22/2018
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Last Update Date | 02/22/2018
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Provider Practice Location Address
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Address Line | 891 W NORTH BEND RD
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City | CINCINNATI
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State | OH
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Zip | 45224-1340
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Country | US
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Telephone | 513-394-0070
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 43141
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City | CINCINNATI
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State | OH
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Zip | 45243-0141
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. ANTHERECA EDMERSON LANE
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Credential | MD
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Telephone | 513-394-0070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35126683
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License Number State | OH
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