Provider Demographics
NPI:1417124546
Name:BYRNE, JANET RUTH
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:RUTH
Last Name:BYRNE
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 1:324 KEHR UNION BLDG
Mailing Address - Street 2:BLOOMSBURG UNIVERSITY STUDENT HEALTH CENTER
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-1301
Mailing Address - Country:US
Mailing Address - Phone:570-389-4451
Mailing Address - Fax:570-389-3417
Practice Address - Street 1:324 KEHR UNION BLDG
Practice Address - Street 2:BLOOMSBURG UNIVERSITY STUDENT HEALTH CENTER
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-1301
Practice Address - Country:US
Practice Address - Phone:570-389-4451
Practice Address - Fax:570-389-3417
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP000661B364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health