Basic Information
| Provider Information | |||||||||
| NPI: | 1619085719 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BISCAN-BANKS | ||||||||
| FirstName: | JANICE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | APRN,BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 109 PLAZA DR | ||||||||
| Address2: | |||||||||
| City: | SAINT CLAIRSVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439507713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406955207 | ||||||||
| FaxNumber: | 7406954116 | ||||||||
| Practice Location | |||||||||
| Address1: | 106 PLAZA DR | ||||||||
| Address2: | |||||||||
| City: | SAINT CLAIRSVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439506700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406955207 | ||||||||
| FaxNumber: | 7406954116 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2006 | ||||||||
| LastUpdateDate: | 05/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 33491 | WV | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 12882-NP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 0064249 | 05 | OH | MEDICAID | 7101215000 | 05 | WV | MEDICAID |