Provider Demographics
NPI:1699112516
Name:DIABETES EDUCATION LEARNING CENTER,LLC
Entity type:Organization
Organization Name:DIABETES EDUCATION LEARNING CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC, CDE
Authorized Official - Phone:740-275-4936
Mailing Address - Street 1:2502 SUNSET BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2437
Mailing Address - Country:US
Mailing Address - Phone:740-275-4936
Mailing Address - Fax:740-275-4829
Practice Address - Street 1:2502 SUNSET BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2437
Practice Address - Country:US
Practice Address - Phone:740-275-4936
Practice Address - Fax:740-275-4829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-01
Last Update Date:2013-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN108593/NP08160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty