Provider Demographics
NPI:1760677009
Name:DOLAN, JANE A (APNP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:A
Last Name:DOLAN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:MEITZNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8004
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54402-8004
Mailing Address - Country:US
Mailing Address - Phone:715-847-2304
Mailing Address - Fax:715-847-2321
Practice Address - Street 1:2720 PLAZA DR
Practice Address - Street 2:SUITE 1400B
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4158
Practice Address - Country:US
Practice Address - Phone:715-847-2004
Practice Address - Fax:715-847-2005
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3262363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner