person
Teresa A Lane
Adult Health Clinical Nurse Specialist in Peoria, Illinois
NPI 1417247776

Teresa A Lane is an Adult Health Clinical Nurse Specialist based in Peoria, IL and is specialized in Adult Health. Teresa A Lane practices in Peoria, IL. The NPI Number for Teresa A Lane is 1417247776 and holds a License No. 209008755 (Illinois).

The current practice location address for Teresa A Lane is 200 E Pennsylvania Ave, Peoria, IL and can be reached out via phone at 309-624-4000 and via fax at 309-624-4010.

Location: 200 E Pennsylvania Ave, Peoria, IL, 61603-3089
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Provider Profile Details
NPI Number
1417247776
Provider Name
Teresa A Lane
Credential
Provider Entity Type
Individual
Gender
Female
Address
200 E Pennsylvania Ave, Peoria, IL, 61603-3089
Phone Number
309-624-4000
Fax Number
309-624-4010
Provider Enumeration Date
04/07/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
370662569 05 IL
institution
Provider Business Practice Location Address Details
Address
200 E Pennsylvania Ave
City
State
Zip
61603-3089
Phone Number
309-624-4000
Fax Number
309-624-4010
person
Provider Business Mailing Address Details
Address
200 E Pennsylvania Ave
City
State
Zip
61603-3089
Phone Number
309-624-4000
Fax Number
309-624-4010
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Clinical Nurse Specialist
Speciality
Adult Health
Taxonomy
License No.
209008755 (Illinois)
Definition
Definition to come...
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