Provider Demographics
NPI:1588536031
Name:LANE, MEGAN YVETTE (APRN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:YVETTE
Last Name:LANE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 MILL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:NANCY
Mailing Address - State:KY
Mailing Address - Zip Code:42544-8878
Mailing Address - Country:US
Mailing Address - Phone:606-875-6990
Mailing Address - Fax:
Practice Address - Street 1:106 WINSTON WAY
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-4953
Practice Address - Country:US
Practice Address - Phone:270-789-0034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4046736207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty