Provider Demographics
NPI:1225438294
Name:BYRD, JANET KAY (FNP-C)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:KAY
Last Name:BYRD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:KAY
Other - Last Name:TWIATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19270 HIGHWAY 12
Mailing Address - Street 2:
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-5414
Mailing Address - Country:US
Mailing Address - Phone:707-939-6070
Mailing Address - Fax:707-939-2272
Practice Address - Street 1:19270 HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-5414
Practice Address - Country:US
Practice Address - Phone:707-939-6070
Practice Address - Fax:707-939-2272
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95000918OtherCA. NP LICENSE NUMBER