Most Relevant Information
Provider Data
| NPI Number: | 1003344045 |
| Provider Name: | STACY JOELLE LANE |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0200X |
| Specialty: | Nurse Practitioner |
| License Number: | 229867 |
Most Important Dates
| Enumeration Date: | 06/02/2017 |
| Last Updated: | 06/02/2017 |
Provider Practice Location
160 DENTAL CIRCLE
CHAPEL HILL
NC
275997064
Practice Location Phone/Fax
| Phone: | 9199664095 |
| Fax: |
Provider Mailing Location
1312 RODESSA RUN
RALEIGH
NC
276076011
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |