Provider Demographics
NPI:1336425008
Name:OELKE, JANE (ND, PHD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:OELKE
Suffix:
Gender:F
Credentials:ND, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 NILES RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-3338
Mailing Address - Country:US
Mailing Address - Phone:269-429-9554
Mailing Address - Fax:269-556-9615
Practice Address - Street 1:2820 NILES RD
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-3338
Practice Address - Country:US
Practice Address - Phone:269-429-9554
Practice Address - Fax:269-556-9615
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
07680175F00000X
07860175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath