Provider Demographics
NPI:1497510630
Name:JANSE, MARIANNE A
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:A
Last Name:JANSE
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:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:ROBERTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44670-0065
Mailing Address - Country:US
Mailing Address - Phone:917-327-9979
Mailing Address - Fax:
Practice Address - Street 1:2023 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1349
Practice Address - Country:US
Practice Address - Phone:740-283-3347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator