Provider Demographics
NPI:1407010762
Name:AST, JANET CHRISTINE
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:CHRISTINE
Last Name:AST
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 1:3001 S CLEMENT AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-2458
Mailing Address - Country:US
Mailing Address - Phone:414-334-3163
Mailing Address - Fax:
Practice Address - Street 1:3001 S CLEMENT AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2458
Practice Address - Country:US
Practice Address - Phone:414-334-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI107480-030163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management