Provider Demographics
NPI:1114985843
Name:WAMSHER, JANE GARRIS (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:GARRIS
Last Name:WAMSHER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:2210 HEMBY LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3773
Mailing Address - Country:US
Mailing Address - Phone:252-752-7133
Mailing Address - Fax:252-752-6120
Practice Address - Street 1:2210 HEMBY LANE
Practice Address - Street 2:SUITE 105
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2801
Practice Address - Country:US
Practice Address - Phone:252-752-7133
Practice Address - Fax:252-752-6120
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC002183222363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC002183222OtherNURSE PRACTICIONER