Provider Demographics
NPI:1568599199
Name:PRATT, JANET (FNP-C, PMHNP-C)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:PRATT
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141N SUNSET BEACH DR
Mailing Address - Street 2:
Mailing Address - City:MANISTIQUE
Mailing Address - State:MI
Mailing Address - Zip Code:49854-8912
Mailing Address - Country:US
Mailing Address - Phone:906-341-5557
Mailing Address - Fax:
Practice Address - Street 1:125 N LAKE ST
Practice Address - Street 2:
Practice Address - City:MANISTIQUE
Practice Address - State:MI
Practice Address - Zip Code:49854-1234
Practice Address - Country:US
Practice Address - Phone:906-341-2144
Practice Address - Fax:906-341-5793
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704159035363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily