Provider Demographics
NPI:1326223397
Name:CHEVRETTE, JANICE F
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:F
Last Name:CHEVRETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:F
Other - Last Name:CHEVRETTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, RN, NP-C, CWOCN
Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-5375
Mailing Address - Fax:651-254-3456
Practice Address - Street 1:640 JACKSON ST - MS 11105A
Practice Address - Street 2:HEALTHPARTNERS REGIONS SPECIALTY CLINICS
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2502
Practice Address - Country:US
Practice Address - Phone:651-254-3456
Practice Address - Fax:651-254-3456
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNF0807332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNR1006155OtherMEDICAL LICENSE NUMBER