Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jessica Lynn Lane, CPNP-PC

Individual provider Pediatric Registered Nurse · NPI 1922767284

Jessica Lynn Lane, CPNP-PC is a Pediatric Registered Nurse in Saint Clair Shores, Michigan. Licensed in Michigan. Registered with an NPI since 2021.

Licensed in
MI
In the registry since
2021
Specialties on file
2

Practice location Address checks out

20225 E 9 Mile Rd
Saint Clair Shores, MI 48080-1700
Phone: (313) 600-5349
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 4704342324 (MI)
Pediatric Registered Nurse Taxonomy 163WP0200X · Licence 4704342324 (MI)

Record details

NPI number1922767284
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPNP-PC
Sole proprietorNo
NPI enumeratedDecember 14, 2021
Last updated in NPPESOctober 26, 2022
Certification dateOctober 26, 2022