MEDICARE: DR. JANA WHEELER DNP, PPCNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	APN18102	SC
2	363L00000X	Nurse Practitioner	APN0000007913	TN

General Provider Information

NPI Number	:	1285800235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANA WHEELER DNP, PPCNP-BC

Provider Business Mailing Address
First Line	:	1055 RIBAUT RD STE 20A
Second Line	:
City	:	BEAUFORT
State	:	SC
Zip	:	29902-3401
Country	:	US
Telephone Number	:	843-379-9993
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 OKATIE CTR BLVD
Second Line	:	BLDG 6. SUITE 201
City	:	OKATIE
State	:	SC
Zip	:	29909-7529
Country	:	US
Telephone Number	:	843-706-3206
Fax Number	:	843-706-3226

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	03/16/2020

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