Provider Demographics
NPI:1780480426
Name:LANE-PRIFTI, JOCELYN RENEE (NP)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:RENEE
Last Name:LANE-PRIFTI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:RENEE
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 CHESTERFIELD PKWY E STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2167
Mailing Address - Country:US
Mailing Address - Phone:314-878-3839
Mailing Address - Fax:
Practice Address - Street 1:1001 CHESTERFIELD PKWY E STE 101
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2167
Practice Address - Country:US
Practice Address - Phone:314-878-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025028297363LF0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program