Provider Demographics
NPI:1376312280
Name:STANTON, JANET SMITH
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:SMITH
Last Name:STANTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 SOUTHERLY DR
Mailing Address - Street 2:
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26836-8769
Mailing Address - Country:US
Mailing Address - Phone:304-257-3434
Mailing Address - Fax:
Practice Address - Street 1:135 SOUTHERLY DR
Practice Address - Street 2:
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836-8769
Practice Address - Country:US
Practice Address - Phone:304-257-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker