Provider Demographics
NPI:1063685675
Name:ESTERVIG, JANET LYNN (RN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LYNN
Last Name:ESTERVIG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4922 N SHERMAN AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-8445
Mailing Address - Country:US
Mailing Address - Phone:608-246-2015
Mailing Address - Fax:
Practice Address - Street 1:4922 N SHERMAN AVE UNIT B
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-8445
Practice Address - Country:US
Practice Address - Phone:608-246-2015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35008300Medicaid