Provider Demographics
NPI:1164180253
Name:JANIE EARLE DNP PC
Entity Type:Organization
Organization Name:JANIE EARLE DNP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EARLE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:435-523-1545
Mailing Address - Street 1:135 E ANTONE WAY
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-8394
Mailing Address - Country:US
Mailing Address - Phone:435-523-1545
Mailing Address - Fax:435-673-8458
Practice Address - Street 1:135 E ANTONE WAY
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-8394
Practice Address - Country:US
Practice Address - Phone:435-523-1545
Practice Address - Fax:435-673-8458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty