Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 32 | WI |
N | 363L00000X | Nurse Practitioner | 2330 | WI |
NPI | 1053335778 |
---|---|
Provider Name | Mrs. Jane Eva Singer |
First Address | Southlake, TX 76092-7000 |
Second Address | Fort Worth, TX 76104-4124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 16/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
41177500 | (05) | WI |
Q01309 | (02) |