| Doctor Name: | ALISA S LANE |
| NPI Number: | 1578806105 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.N.P. |
| License Number: | 80451 |
| Business Practice Address: | 197 Pleasant St Hinton, WV - 259512540 |
| Business Phone Number: | 3044662501 |
| Business Fax Number: | 3044664212 |
| Mailing Address: | 197 Pleasant St, HINTON |
| State: | WV |
| Postal Code: | 259512540 |
| Phone Number: | 3044662501 |
| Fax Number: | 3044664212 |
| NPI Enumeration Date: | 04/02/2013 |
| NPI Last Update Date: | 04/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 80451 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |