Individual
JANE HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
95429 BARNWELL RD, FERNANDINA BEACH, FL 32034-1698
(904) 321-3533
(517) 787-7365
Mailing address
95429 BARNWELL RD, FERNANDINA BEACH, FL 32034-1698
(904) 321-3533
(517) 787-7365
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
9271732
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000024026
ANTHEM PIN
OH
05
—
0184901
—
OH
01
—
1215930425
GROUP NPI
OH
01
—
430036019
TRAVELERS
OH
Enumeration date
06/21/2005
Last updated
05/16/2013
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