KRISTOPHER OLEN LANE (NPI# 1306378856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306378856 |
| Entity Type | Individual |
| Full Name | KRISTOPHER OLEN LANE |
| Credential | FNP |
| Practice Address |
122 Latimer St Latta SC 29565-1828 |
| Mailing Address |
Po Box 1090 Hartsville SC 29551-1090 |
| Practice Telephone | 8436276252 |
| Mailing Telephone | (843) 857-0111 |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-09-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
20909 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP4553 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134549025 | Kristopher Martin Lane | Chiropractor | 7631 212th St Sw, 105b, Edmonds, WA 98026-7565 | 2014-04-18 |
| Street Address |
122 LATIMER ST |
| City | LATTA |
| State | SC |
| Zip Code | 29565-1828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487766549 | Carolyn Whitfield Fulmore | Counselor | 122 Latimer St, Latta, SC 29565-1828 | 2006-08-31 |
| 1336506427 | Caresouth Carolina Inc | Pharmacy | 122 Latimer St, Latta, SC 29565-1828 | 2016-01-21 |
| 1972980621 | Caresouth Carolina Inc | Clinic/Center | 122 Latimer St, Latta, SC 29565-1828 | 2015-05-01 |
| 1386983294 | Susan T Brown | Registered Nurse | 122 Latimer St, Latta, SC 29565-1828 | 2013-02-13 |
| 1841525631 | James Bernard Fleming | Family Medicine | 122 Latimer St, Latta, SC 29565-1828 | 2009-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619409901 | Archie Brown | Nurse Practitioner | 122 Latimer St., Latta, SC 29565 | 2017-03-28 |
| 1841383551 | Latta Rescue Squad, Inc. | Ambulance | 107 West Bambergg Street, Latta, SC 29565 | 2006-10-02 |
| 1023021227 | Dillon County School District Three | Local Education Agency (LEA) | 205 King St, Latta, SC 29565 | 2006-08-15 |
| 1952684433 | Cox Speech-language Pathology, Inc. | Speech-Language Pathologist | 108 N Mauldin St, Latta, SC 29565-1319 | 2011-09-21 |
| 1215347968 | Med Atlantic | Non-emergency Medical Transport (VAN) | 108 N Mauldin St, Latta, SC 29565-1319 | 2014-05-03 |
| 1598004475 | Sandra Jones | Psychologist | 205 King St, Latta, SC 29565-1401 | 2013-02-12 |
| 1225377336 | Denise Marie Gallant | Psychologist | 205 King St, Latta, SC 29565-1401 | 2013-02-08 |
| 1467791335 | Anita Graves Mace | Registered Nurse | 602 N Richardson St, Latta, SC 29565-1416 | 2013-02-12 |
| 1871579557 | Raeford Lee Clanton | Dentist | 203 S Marion St, Latta, SC 29565-1522 | 2005-12-15 |
| 1992032486 | Modern Legacy, Inc. | Dentist | 203 S Marion St, Latta, SC 29565-1522 | 2009-11-04 |
| Find all providers in zip 29565 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619409901 | Archie Brown | Nurse Practitioner | 122 Latimer St., Latta, SC 29565 | 2017-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557737 | Diondra Johnson | Nurse Practitioner | 2327 Watchtower Ln, Charleston, SC 29414-7803 | 2020-10-27 |
| 1740888262 | Gerri Kukucka | Nurse Practitioner | 18 Ash Ct, Irmo, SC 29063-9584 | 2020-10-16 |
| 1407454853 | William Andrew Haislip | Nurse Practitioner | 109 Anita St, Greer, SC 29651-3814 | 2020-10-16 |
| 1912505652 | Mattison Williams Craig | Nurse Practitioner | 108 Woodstock Ln, Greer, SC 29650-3918 | 2020-10-14 |
| 1669079901 | Kelley Brown Davis | Nurse Practitioner | 2689 Us-1, Elgin, SC 29045 | 2020-10-08 |
| 1518564897 | Erica Odom Mccumbers | Nurse Practitioner | 17 Downing Cir, Gilbert, SC 29054-8483 | 2020-10-08 |
| 1285231845 | Shannon Marie Dunlap | Nurse Practitioner | 3792 Home Branch Rd, Manning, SC 29102-4109 | 2020-10-07 |
| 1588261325 | Crystal Leopard | Nurse Practitioner | 328 Deer Creek Rd, Easley, SC 29640-7615 | 2020-10-05 |
| 1497352595 | Margaret Ann Regnery | Nurse Practitioner | 900 Island Park Dr Ste 104, Daniel Island, SC 29492-7560 | 2020-10-02 |
| 1417564709 | John P Rainchuso | Nurse Practitioner | 299 Three Runs Creek Way, Aiken, SC 29803-1680 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.