Herzog, Jane

Herzog, Jane is an individual health care provider with primary practice located at 95429 Barnwell Rd , Fernandina Beach FL 32034-1698. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Herzog, Jane can be contacted via phone (904) 321-3533.

Contact Information

Primary practice address
95429 Barnwell Rd Fernandina Beach FL 32034-1698
Phone: (904) 321-3533
Fax: (517) 787-7365
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 9271732 Florida

Profile Details

NPI number 1992701403
LBN Legal business name Herzog, Jane
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated May 16th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992701403 NPPES
Ohio MEDICAID 0184901
Ohio Other 000000024026
Ohio Other 1215930425
Ohio Other 430036019

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