Provider Demographics
NPI:1417732579
Name:BORNE, JANE MICHELLE (RPH)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:MICHELLE
Last Name:BORNE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7240 KELTNER DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-8205
Mailing Address - Country:US
Mailing Address - Phone:612-306-5263
Mailing Address - Fax:
Practice Address - Street 1:11310 CORNELL PARK DR
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-1814
Practice Address - Country:US
Practice Address - Phone:513-782-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115819183500000X
KY023688183500000X
OH03135304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist