Provider Demographics
NPI:1275741316
Name:MOSHER, JANIS HELEN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:HELEN
Last Name:MOSHER
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 1:70 BLOODY BROOK RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841-2124
Mailing Address - Country:US
Mailing Address - Phone:603-770-3282
Mailing Address - Fax:
Practice Address - Street 1:70 BLOODY BROOK RD
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03841-2124
Practice Address - Country:US
Practice Address - Phone:603-770-3282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA131640163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0709476Medicaid