Lane Tupa
Student in an Organized Health Care Education/Training Program in Jackson, TN. Individual provider (NPI-1).
NPI number1245060367
StatusActive
Last updated in NPPESApr 9, 2025
Details
- NPI
- 1245060367
- Entity type
- Individual (NPI-1)
- Name
- Lane Tupa
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 5, 2024
- Certification date
- Apr 9, 2025
- Last updated
- Apr 9, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
700 W Forest Ave Fl 5Jackson, TN 38301-3937
Phone 731-541-3755
Mailing address
12100 Rainwood Rd Apt 38Little Rock, AR 72212-3936
Phone 870-678-3141
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Other Student in an Organized Health Care Education/Training Program providers in Jackson, TN
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All 38 Student in an Organized Health Care Education/Training Program providers in Jackson · All 3,212 providers in Jackson
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