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Mr. Jeremy Lane JR., PA-C
Surgical Physician Assistant in St Louis Park, Minnesota
NPI 1144205220

Jeremy Lane JR. is a Surgical Physician Assistant based in St Louis Park, MN and is specialized in Surgical. Jeremy Lane JR. practices in St Louis Park, MN and has the professional credentials of PA-C. The NPI Number for Jeremy Lane JR. is 1144205220 and holds a License No. 9937 (Minnesota).

The current practice location address for Jeremy Lane JR. is 3931 Louisiana Ave S, St Louis Park, MN and can be reached out via phone at 952-993-3230 and via fax at 952-993-1748.

Location: 3931 Louisiana Ave S, St Louis Park, MN, 55426-5000
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144205220
Provider Name
Jeremy Lane JR.
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
3931 Louisiana Ave S, St Louis Park, MN, 55426-5000
Phone Number
952-993-3230
Fax Number
952-993-1748
Provider Enumeration Date
12/12/2005
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
3931 Louisiana Ave S
City
St Louis Park
State
Minnesota
Zip
55426-5000
Phone Number
952-993-3230
Fax Number
952-993-1748
person
Provider Business Mailing Address Details
Address
3931 Louisiana Ave S
City
St Louis Park
State
Minnesota
Zip
55426-5000
Phone Number
952-993-3230
Fax Number
952-993-1748
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
363AS0400X
License No.
9937 (Minnesota)
Definition
Definition to come...
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