Provider Demographics
NPI:1275910036
Name:FORGE, JANET
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:FORGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:MARIE
Other - Last Name:FORGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN-CNS
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-1916
Mailing Address - Fax:913-588-4720
Practice Address - Street 1:2330 SHAWNEE MISSION PKWY
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-2005
Practice Address - Country:US
Practice Address - Phone:913-588-1916
Practice Address - Fax:913-588-4720
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75390-051163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology