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

Nicole Renea Lane, NPADULTGERONTOLOGY

Individual provider Nurse Practitioner · NPI 1942744222

Nicole Renea Lane, NPADULTGERONTOLOGY is a Nurse Practitioner in Saint Louis, Missouri. Licensed in Kansas. Registered with an NPI since 2016.

Licensed in
KS
In the registry since
2016

Practice location Address checks out

12401 Olive Blvd
Saint Louis, MO 63141-5443
Phone: (314) 390-0135
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 77185 (KS)

Record details

NPI number1942744222
Entity typeIndividual (Type 1)
GenderFemale
Credentials NPADULTGERONTOLOGY
Sole proprietorNo
NPI enumeratedDecember 6, 2016
Last updated in NPPESSeptember 28, 2021
Certification dateSeptember 28, 2021

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