Provider Demographics
NPI:1255359949
Name:HARPER, JANINE ANN (CRNA)
Entity type:Individual
Prefix:MS
First Name:JANINE
Middle Name:ANN
Last Name:HARPER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:A
Other - Last Name:WIEWEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 7687
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65205-7687
Mailing Address - Country:US
Mailing Address - Phone:573-882-2259
Mailing Address - Fax:
Practice Address - Street 1:ONE HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-2568
Practice Address - Fax:573-882-2226
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003005972367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO918821703Medicaid
MO918821703Medicaid
IL$$$$$$$$$001Medicaid
MO918821703Medicaid
815550042Medicare PIN
P00161789Medicare PIN