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NPI Code Detail

MEDICARE: JOAN VAN DER BIJL MSN, CNS

MEDICARE: JOAN VAN DER BIJL MSN, CNS
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
1364SP0809XAdult Psychiatric/Mental Health Clinical Nurse SpecialistNS-02624OH
2364SP0811XChronically Ill Psychiatric/Mental Health Clinical Nurse SpecialistNS-02624OH
3364SP0812XCommunity Psychiatric/Mental Health Clinical Nurse SpecialistNS-02624OH
4364SP0813XGeropsychiatric Psychiatric/Mental Health Clinical Nurse SpecialistNS-02624OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598741829
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN VAN DER BIJL MSN, CNS
Provider Business Mailing Address
First Line : 1425 STARR AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43605-2456
Country : US
Telephone Number : 419-693-0631
Fax Number :
Provider Business Practice Location Address
First Line : 1425 STARR AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43605-2456
Country : US
Telephone Number : 419-693-0631
Fax Number : 419-936-7546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 07/22/2015

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