Provider Demographics
NPI:1871634634
Name:JANTZ, JOYCE ANN
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:ANN
Last Name:JANTZ
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 1:1117 CASTINE RD
Mailing Address - Street 2:
Mailing Address - City:ORLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04472
Mailing Address - Country:US
Mailing Address - Phone:207-469-2302
Mailing Address - Fax:
Practice Address - Street 1:1117 CASTINE RD
Practice Address - Street 2:
Practice Address - City:ORLAND
Practice Address - State:ME
Practice Address - Zip Code:04472
Practice Address - Country:US
Practice Address - Phone:207-469-2302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER034378163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse