Individual provider Active NPI

Wendy Ann Lane, RN, CRNFA

  • Registered Nurse First Assistant
  • Duluth, MN
National Provider Identifier
1639422678
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
R133454-2 Issued in MN
Practice address
2622 E 6TH St
Duluth, MN 55812-1504
Phone
(218) 340-3958
NPI assigned
Oct 15, 2012
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X R133454-2 MN Primary

Addresses

Primary practice location

2622 E 6TH St
Duluth, MN 55812-1504

Mailing address

2622 E 6TH St
Duluth, MN 55812-1504
Phone (218) 340-3958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R133454-2MNMDRegistered Nurse First Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1639422678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2622 E 6TH ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121504",
            "telephone_number": "218-340-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 E 6TH ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121504",
            "telephone_number": "218-340-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "WENDY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RN, CRNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MN",
            "license": "R133454-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.