# JANA VAN WIE, M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669781225
- **Authorized official:** JANA G VAN WIE M.D. (OWNER)
- **Authorized official phone:** (308) 384-3457

## Contact information

- **Practice address:** 1917 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4642
- **Practice address phone:** (308) 384-3457
- **Mailing address:** 1917 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4642
- **Mailing address phone:** (308) 384-3457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 16706 | NE | Yes |

## Other

- **Enumeration date:** 09/30/2010
- **Last updated:** 09/30/2010