Provider Demographics
NPI:1528319696
Name:SCHUERCH, JANA LYNN (DHAT)
Entity type:Individual
Prefix:MISS
First Name:JANA
Middle Name:LYNN
Last Name:SCHUERCH
Suffix:
Gender:F
Credentials:DHAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:KIANA
Mailing Address - State:AK
Mailing Address - Zip Code:99749-0130
Mailing Address - Country:US
Mailing Address - Phone:907-475-2199
Mailing Address - Fax:907-475-2198
Practice Address - Street 1:130 CASONOFF STREET
Practice Address - Street 2:
Practice Address - City:KIANA
Practice Address - State:AK
Practice Address - Zip Code:99749-0130
Practice Address - Country:US
Practice Address - Phone:907-475-2199
Practice Address - Fax:907-475-2198
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK12-095-DHAT247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other