Provider Demographics
NPI:1316284094
Name:LANE, ALANNA JEANNINE (STNA)
Entity type:Individual
Prefix:MRS
First Name:ALANNA
Middle Name:JEANNINE
Last Name:LANE
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 AMES ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-4609
Mailing Address - Country:US
Mailing Address - Phone:740-485-3030
Mailing Address - Fax:
Practice Address - Street 1:113 MARITA DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-2911
Practice Address - Country:US
Practice Address - Phone:740-397-5381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400442911204376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide