Provider Demographics
NPI:1396116042
Name:UNRUE, JAYNE (PMHNP)
Entity type:Individual
Prefix:
First Name:JAYNE
Middle Name:
Last Name:UNRUE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TUSCARAWAS ST W STE 200
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44702-2044
Mailing Address - Country:US
Mailing Address - Phone:330-438-2400
Mailing Address - Fax:330-438-3003
Practice Address - Street 1:400 TUSCARAWAS ST W STE 200
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-2044
Practice Address - Country:US
Practice Address - Phone:330-438-2400
Practice Address - Fax:330-438-3003
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.406532163WP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health