Provider Demographics
NPI:1316287436
Name:LANE, KAREN (MSN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 UDALL ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-1654
Mailing Address - Country:US
Mailing Address - Phone:619-806-0928
Mailing Address - Fax:619-523-4099
Practice Address - Street 1:4305 GESNER ST STE 101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6673
Practice Address - Country:US
Practice Address - Phone:619-806-0928
Practice Address - Fax:619-523-4099
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311949163WP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0000XNursing Service ProvidersRegistered NursePain Management