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General NPI Number Information
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NPI Number | 1578040259
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Entity Type | Organization
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Legal Business Name | JANEYJANEJANEARNP-CNP LLC
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Dates
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Enumeration Date | 07/25/2018
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 204 N MAIN
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City | SEILING
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State | OK
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Zip | 73663-0404
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Country | US
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Telephone | 580-362-0943
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Fax | 303-353-1969
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Provider Business Mailing Address
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Address Line | PO BOX 404
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City | SEILING
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State | OK
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Zip | 73663-0404
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Country | US
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Telephone | 580-922-4406
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Fax | 580-922-4890
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Authorized Official
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Title or Position | SOLE MEMBER, OWNER
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Name | MRS. JANEY NICOLE HAMMONS
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Credential | NP-C
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Telephone | 580-922-4406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 81466
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License Number State | OK
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