=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831006170
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MORGAN RAE LANE NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2026
-----------------------------------------------------
Last Update Date | 08/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2076 COLLINS RD
-----------------------------------------------------
City | COLLINS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44826-9732
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-306-0579
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2076 COLLINS RD
-----------------------------------------------------
City | COLLINS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44826-9732
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-306-0579
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | APRN.CNP.0043000
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------