Basic Information
Provider Information
NPI: 1477722254
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEYER
FirstName: JANE
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1120 CITRUS TOWER BLVD
Address2: SUITE 325
City: CLERMONT
State: FL
PostalCode: 347111909
CountryCode: US
TelephoneNumber: 3522417275
FaxNumber: 3522417281
Practice Location
Address1: 1120 CITRUS TOWER BLVD
Address2: SUITE 325
City: CLERMONT
State: FL
PostalCode: 347111909
CountryCode: US
TelephoneNumber: 3522417275
FaxNumber: 3522417281
Other Information
ProviderEnumerationDate: 02/26/2008
LastUpdateDate: 02/26/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LX0001XARNP1350352FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology

No ID Information.


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