Provider Demographics
NPI:1487284840
Name:LANE, DALANA DAWN (NP)
Entity type:Individual
Prefix:
First Name:DALANA
Middle Name:DAWN
Last Name:LANE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 S INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:VA
Mailing Address - Zip Code:24348-2802
Mailing Address - Country:US
Mailing Address - Phone:276-773-2063
Mailing Address - Fax:855-407-5619
Practice Address - Street 1:217 S INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:VA
Practice Address - Zip Code:24348-2802
Practice Address - Country:US
Practice Address - Phone:276-773-2063
Practice Address - Fax:855-407-5619
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015310363L00000X, 363LF0000X
GAGAA-NP000892363LF0000X
VA0024178742363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily