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General NPI Number Information
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NPI Number | 1689672453
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Entity Type | Individual
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Provider Name | LANE S RAKER NP
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Gender | Female
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 824 GREENBRIER PKWY SUITE 100
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3697
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Country | US
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Telephone | 757-410-7390
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Fax | 757-410-7395
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Provider Business Mailing Address
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Address Line | 914 GRAYDON AVE
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City | NORFOLK
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State | VA
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Zip | 23507-1208
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Country | US
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Telephone | 757-624-9518
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Fax |
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 0024062335
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License Number State | VA
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