Provider Demographics
NPI:1184180242
Name:WEST, JANICE LOUISE (RN)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LOUISE
Last Name:WEST
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:HUGHES
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:212 ARIANA PL
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-2534
Mailing Address - Country:US
Mailing Address - Phone:863-224-3029
Mailing Address - Fax:
Practice Address - Street 1:210 1ST ST N
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4526
Practice Address - Country:US
Practice Address - Phone:863-353-1390
Practice Address - Fax:863-438-4880
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9182279163WC3500X
FLAPRN11001469207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation