Most Relevant Information
Provider Data
| NPI Number: | 1003827478 |
| Provider Name: | JASON TODD LANE CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | R852446 |
Most Important Dates
| Enumeration Date: | 08/11/2006 |
| Last Updated: | 02/07/2019 |
Provider Practice Location
215 MARION AVE
MCCOMB
MS
396482705
Practice Location Phone/Fax
| Phone: | 6012495500 |
| Fax: | 6012491709 |
Provider Mailing Location
1210 PARKLANE RD
APT 7D
MCCOMB
MS
396484904
Provider Mailing Phone/Fax
| Phone: | 6013472739 |
| Fax: |