Provider Demographics
NPI:1275157216
Name:WYCHE, JANYE
Entity Type:Individual
Prefix:
First Name:JANYE
Middle Name:
Last Name:WYCHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 JONATHAN PL
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-6957
Mailing Address - Country:US
Mailing Address - Phone:706-910-6977
Mailing Address - Fax:
Practice Address - Street 1:1619 JONATHAN PL
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-6957
Practice Address - Country:US
Practice Address - Phone:706-910-6977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider