Mary Kay Lane, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Fosston, MN
NPI 1497843593 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497843593
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- R15886-4 (MN)
- Practice address
- 900 Hilligoss Blvd SE
Fosston, MN 56542-1542 - Phone
- (218) 435-1133
- Fax
- (218) 435-1134
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1545 | MN | MD | Acupuncturist |
| R15886-4 | MN | MD | Certified Registered Nurse Anesthetist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R15886-4 | MN | Yes |
Addresses
Primary practice location
900 Hilligoss Blvd SE
Fosston, MN 56542-1542
Mailing address
900 Hilligoss Blvd SE
Fosston, MN 56542-1542
Phone (218) 435-1133
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1034717 | Other | MN | PREFERRED ONE NUMBER |
| 373T8LA | Other | MN | BLUE CROSS NUMBER |
Other providers in Fosston, MN
- Independent School District #601
- Amanda Christine Jackson-Morgan
- Bryan Mikael Johnson
- Nicole Marie Kiesow
- Daniele R Krouse
- Ashlee M Lee
- Shyanne Loiland
- Marfa Ivanovna Mametieff
- Mitchell Dick Marquis
- Tyler McGlynn
All providers in Fosston, MN · Certified Registered Nurse Anesthetist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.