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Stephanie Breanne Lane

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

40 Autumn Fern Trl, Lillington, NC 27546-5155

PECOS Enrollment

This provider is enrolled in PECOS as STEPHANIE LANE.

Based on the most recent information from CMS, provider Stephanie Breanne Lane is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1992307623
Provider Type
Individual
Full Name
Lane, Stephanie Breanne
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
11/9/2020
Last Updated
11/9/2020

Contact Information

Practice Location

40 Autumn Fern Trl, Lillington, NC 27546-5155

(910) 364-0971

Unlisted Fax

Mailing Location

40 Autumn Fern Trl, Lillington, NC 27546-5155

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 0010-10714 North Carolina

Stephanie Breanne Lane

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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