Provider Demographics
NPI:1992056477
Name:LANE, JENNIFER FRANEL (DVM)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:FRANEL
Last Name:LANE
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1439
Mailing Address - Street 2:
Mailing Address - City:LABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:33975-1439
Mailing Address - Country:US
Mailing Address - Phone:254-541-3292
Mailing Address - Fax:
Practice Address - Street 1:4455 MARINER RD
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-3964
Practice Address - Country:US
Practice Address - Phone:254-541-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA000007114174M00000X
CA16485174M00000X
VA0301200575174M00000X
FLVM12678174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian