Provider Demographics
NPI:1598459794
Name:ELLERBE, JANET T
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:T
Last Name:ELLERBE
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 1:145 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-3809
Mailing Address - Country:US
Mailing Address - Phone:843-623-4767
Mailing Address - Fax:
Practice Address - Street 1:145 W OAK ST
Practice Address - Street 2:
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-3809
Practice Address - Country:US
Practice Address - Phone:843-623-4767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker