Basic Information
| Provider Information | |||||||||
| NPI: | 1346234101 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JEANES | ||||||||
| FirstName: | NINA | ||||||||
| MiddleName: | VANN | ||||||||
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| Credential: | M.D., PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10110 MOLECULAR DR | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012792779 | ||||||||
| FaxNumber: | 3012792767 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 RUSSELL AVE | ||||||||
| Address2: | |||||||||
| City: | GAITHERSBURG | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012164157 | ||||||||
| FaxNumber: | 3019876297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2005 | ||||||||
| LastUpdateDate: | 12/11/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | D0012101 | MD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.