| Doctor Name: | LESLIE V LANE |
| NPI Number: | 1093131013 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 18601 |
| Business Practice Address: | 389 Forge Ridge Rd Harrogate, TN - 377527730 |
| Business Phone Number: | 4238695893 |
| Business Fax Number: | 4238693574 |
| Mailing Address: | 900 E Hill Ave, Suite 230 KNOXVILLE |
| State: | TN |
| Postal Code: | 379152566 |
| Phone Number: | 8658623563 |
| Fax Number: | 8655441861 |
| NPI Enumeration Date: | 03/14/2014 |
| NPI Last Update Date: | 08/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 18601 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |