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General NPI Number Information
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NPI Number | 1164180253
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Entity Type | Organization
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Legal Business Name | JANIE EARLE DNP PC
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 135 E ANTONE WAY
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City | WASHINGTON
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State | UT
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Zip | 84780-8394
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Country | US
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Telephone | 435-523-1545
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Fax | 435-673-8458
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Provider Business Mailing Address
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Address Line | 135 E ANTONE WAY
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City | WASHINGTON
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State | UT
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Zip | 84780-8394
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Country | US
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Telephone | 435-523-1545
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Fax | 435-673-8458
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | JANIE EARLE
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Credential | DNP
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Telephone | 435-523-1545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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