Provider Demographics
NPI:1316246697
Name:WHITED, JANA M (FNP-BC)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:M
Last Name:WHITED
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1322 MAPLEWOOD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:RONCEVERTE
Mailing Address - State:WV
Mailing Address - Zip Code:24970-8016
Mailing Address - Country:US
Mailing Address - Phone:304-647-1145
Mailing Address - Fax:304-647-3006
Practice Address - Street 1:1322 MAPLEWOOD AVE STE A
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-8016
Practice Address - Country:US
Practice Address - Phone:304-647-5114
Practice Address - Fax:304-647-3006
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV68440363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner