=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669300521
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANE DRASBA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2026
-----------------------------------------------------
Last Update Date | 05/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60 GLENMAURA NATIONAL BLVD
-----------------------------------------------------
City | MOOSIC
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18507-2101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-471-2686
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 60 GLENMAURA NATIONAL BLVD
-----------------------------------------------------
City | MOOSIC
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18507-2101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-471-2686
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | SP035065
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------