Provider Demographics
NPI:1235687567
Name:ALLEN, JANET (RN BSN CBIS)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN BSN CBIS
Other - Prefix:MRS
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:BACHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ADMINISTRATOR
Mailing Address - Street 1:4421 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2304
Mailing Address - Country:US
Mailing Address - Phone:989-832-9026
Mailing Address - Fax:
Practice Address - Street 1:4421 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2304
Practice Address - Country:US
Practice Address - Phone:989-832-9026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAM560083703310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility