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General NPI Number Information
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NPI Number | 1699112516
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Entity Type | Organization
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Legal Business Name | DIABETES EDUCATION LEARNING CENTER,LLC
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Dates
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Enumeration Date | 06/01/2013
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Last Update Date | 06/01/2013
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Provider Practice Location Address
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Address Line | 2502 SUNSET BLVD SUITE B
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City | STEUBENVILLE
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State | OH
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Zip | 43952-2437
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Country | US
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Telephone | 740-275-4936
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Fax | 740-275-4829
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Provider Business Mailing Address
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Address Line | 2502 SUNSET BLVD SUITE B
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City | STEUBENVILLE
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State | OH
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Zip | 43952-2437
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Country | US
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Telephone | 740-275-4936
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Fax | 740-275-4829
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Authorized Official
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Title or Position | OWNER/PROGRAM COORDINATOR
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Name | MRS. JANE ANNE SCOTT
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Credential | FNP-BC, CDE
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Telephone | 740-275-4936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN108593/NP08160
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License Number State | OH
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