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Individual
JANE D CHAMPION
Active
Individual
JANE D CHAMPION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., C.S., F.N.P
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
239515
TX
2083P0901X
Public Health & General Preventive Medicine Physician
239515
TX
208D00000X
General Practice Physician
239515
TX
363LF0000X
Family Nurse Practitioner
Primary
239515
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017801401
—
TX
05
—
029245002
—
TX
05
—
029245003
—
TX
05
—
063389301
—
TX
05
—
083850001
—
TX
01
—
239515
STATE LICENSE
TX
Enumeration date
06/08/2005
Last updated
11/13/2014
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