Provider Demographics
NPI:1073755690
Name:NYLAND, JANA L (SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANA
Middle Name:L
Last Name:NYLAND
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 E HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661-9473
Mailing Address - Country:US
Mailing Address - Phone:785-533-8249
Mailing Address - Fax:
Practice Address - Street 1:611 31ST ST
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:KS
Practice Address - Zip Code:67490-8740
Practice Address - Country:US
Practice Address - Phone:785-658-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS503235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist