Individual
JAYNE P VAN TOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
180 MAIN ST, NORWAY, ME 04268
(207) 743-5933
Mailing address
180 MAIN STREET, NORWAY, ME 04268
(207) 743-5933
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100407
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47078557515
—
NE
Enumeration date
05/12/2006
Last updated
09/05/2012
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