Provider Demographics
NPI:1730454695
Name:LANE, DEBORAH LEE (BS)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LEE
Last Name:LANE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:LEE
Other - Last Name:TOVAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:1167 SPRATLIN PARK DR
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-6205
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3644
Practice Address - Street 1:2001 STONEBROOK PL
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4000
Practice Address - Country:US
Practice Address - Phone:423-224-1000
Practice Address - Fax:423-467-3644
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator