Doctor Name: | MS. JANE A WINE |
NPI Number: | 1255668745 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 22844 |
Business Practice Address: | 106 Plaza Dr Saint Clairsville, OH - 439508736 |
Business Phone Number: | 7406992730 |
Business Fax Number: | |
Mailing Address: | 106 Plaza Dr, SAINT CLAIRSVILLE |
State: | OH |
Postal Code: | 439508736 |
Phone Number: | 7406992730 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2009 |
NPI Last Update Date: | 11/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 22844 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |