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General NPI Number Information
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NPI Number | 1487840120
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Entity Type | Individual
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Provider Name | JANE M ROOT MSN
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Gender | Female
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Dates
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Enumeration Date | 09/17/2007
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 104 JAVIT COURT
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City | AUSTINTOWN
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State | OH
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Zip | 44515-3117
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Country | US
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Telephone | 330-797-9405
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Fax | 330-953-1758
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Provider Business Mailing Address
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Address Line | 104 JAVIT COURT
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City | AUSTINTOWN
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State | OH
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Zip | 44515-3117
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Country | US
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Telephone | 330-797-9405
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Fax | 330-953-1758
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | RN12943
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License Number State | OH
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