Provider Demographics
NPI:1295003168
Name:MOGAN, JANICE LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:LYNN
Last Name:MOGAN
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 1:1801 SE 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5532
Mailing Address - Country:US
Mailing Address - Phone:352-629-0137
Mailing Address - Fax:352-694-4824
Practice Address - Street 1:1801 SE 32ND AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5532
Practice Address - Country:US
Practice Address - Phone:352-629-0137
Practice Address - Fax:352-694-4824
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0995082163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health