# JANA G VAN WIE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1720062458
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 2801-16706 | NE | — |
| 207Q00000X | Family Medicine Physician | 16706 | NE | Yes |

## Other

- **Enumeration date:** 12/06/2005
- **Last updated:** 03/16/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 097552 | GROUP PTAN | NE |
| 01 | — | 097552008 | PTAN | NE |
| 05 | — | 10025894200 | — | NE |
| 01 | — | 1033117015 | GROUP NPI | NE |
| 01 | — | 1669781225 | GROUP NPI | NE |
| 01 | — | 1720062458 | NPI | NE |
| 01 | — | 248833 | MIDLANDS CHOICE | NE |
| 01 | — | 45359 | BCBS | NE |
| 01 | — | 6501500001 | MEDICARE DME PTAN | NE |
| 01 | — | P00885788 | RR MEDICARE | NE |