| Doctor Name: | AMY MICHELLE LANE |
| NPI Number: | 1659475911 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 002158 |
| Business Practice Address: | 410 Salem Tpke Bozrah, CT - 063341519 |
| Business Phone Number: | 8608230245 |
| Business Fax Number: | 8602138350 |
| Mailing Address: | 410 Salem Tpke, BOZRAH |
| State: | CT |
| Postal Code: | 063341519 |
| Phone Number: | 8608230245 |
| Fax Number: | 8602138350 |
| NPI Enumeration Date: | 09/08/2006 |
| NPI Last Update Date: | 06/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 002158 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |