Provider Demographics
NPI:1922795111
Name:PRESAS, JANIE SUE (CST, SFA)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:SUE
Last Name:PRESAS
Suffix:
Gender:F
Credentials:CST, SFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30453-4605
Mailing Address - Country:US
Mailing Address - Phone:912-557-1000
Mailing Address - Fax:
Practice Address - Street 1:247 S MAIN ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30453-4605
Practice Address - Country:US
Practice Address - Phone:912-557-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant