MEDICARE: LANE WOMEN'S HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	35126683	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457852790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANE WOMEN'S HEALTH, LLC

Provider Business Mailing Address
First Line	:	PO BOX 43141
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45243-0141
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	891 W NORTH BEND RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-1340
Country	:	US
Telephone Number	:	513-394-0070
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. ANTHERECA EDMERSON LANE
Credential	:	MD
Telephone Number	:	513-394-0070

Provider Enumeration Date	:	02/22/2018
Last Update Date	:	02/22/2018

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Directions to “LANE WOMEN'S HEALTH, LLC ” Practice Location

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