Provider Demographics
NPI:1891963427
Name:LANE-SANDT, SUSANNE N (CRNP)
Entity type:Individual
Prefix:
First Name:SUSANNE
Middle Name:N
Last Name:LANE-SANDT
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:SUSANNE
Other - Middle Name:N
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1605 N CEDAR CREST BLVD STE 110B
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1442
Practice Address - Street 1:1605 N CEDAR CREST BLVD STE 110B
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2351
Practice Address - Country:US
Practice Address - Phone:610-973-1410
Practice Address - Fax:610-973-1442
Is Sole Proprietor?:No
Enumeration Date:2008-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009627363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily