Provider Demographics
NPI:1033573621
Name:STATON, JANICE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:STATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 CAMPOSTELLA RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-3656
Mailing Address - Country:US
Mailing Address - Phone:757-632-6824
Mailing Address - Fax:757-689-0241
Practice Address - Street 1:2737 CAMPOSTELLA RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-3656
Practice Address - Country:US
Practice Address - Phone:757-632-6824
Practice Address - Fax:757-689-0241
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1603177251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health