Healthcare Provider Details

I. General information

NPI: 1336425008
Provider Name (Legal Business Name): JANE OELKE ND, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2011
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 NILES RD
SAINT JOSEPH MI
49085-3338
US

IV. Provider business mailing address

2820 NILES RD
SAINT JOSEPH MI
49085-3338
US

V. Phone/Fax

Practice location:
  • Phone: 269-429-9554
  • Fax: 269-556-9615
Mailing address:
  • Phone: 269-429-9554
  • Fax: 269-556-9615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number07680
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number07860
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: