Provider Demographics
NPI:1578564803
Name:POINDEXTER, JANET L (FNP-C)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:POINDEXTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 PRISTINE LN
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-9308
Mailing Address - Country:US
Mailing Address - Phone:919-413-3836
Mailing Address - Fax:877-720-2076
Practice Address - Street 1:3803 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2593
Practice Address - Country:US
Practice Address - Phone:919-413-3836
Practice Address - Fax:877-720-2076
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS82755Medicare UPIN