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General NPI Number Information
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NPI Number | 1558205245
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Entity Type | Individual
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Provider Name | SHELLY LANE
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Gender | Female
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 2501 W 22ND ST
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1305
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Country | US
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Telephone | 605-333-6805
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Fax |
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Provider Business Mailing Address
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Address Line | 1608 W THORA CIR
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City | SIOUX FALLS
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State | SD
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Zip | 57108-3238
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Country | US
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Telephone | 605-333-6805
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Fax | 605-373-4150
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number |
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License Number State | SD
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