Provider Demographics
NPI:1073633525
Name:BALYER, JANE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:
Last Name:BALYER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:OBERLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44074-0034
Mailing Address - Country:US
Mailing Address - Phone:440-774-1122
Mailing Address - Fax:
Practice Address - Street 1:46740 BUTTERNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074-9777
Practice Address - Country:US
Practice Address - Phone:440-774-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN102657164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse