Provider Demographics
NPI:1609930221
Name:ELSWICK, JANET SUSAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:SUSAN
Last Name:ELSWICK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 498
Mailing Address - Street 2:
Mailing Address - City:KEEN MOUNTAIN
Mailing Address - State:VA
Mailing Address - Zip Code:24624-0498
Mailing Address - Country:US
Mailing Address - Phone:276-935-2880
Mailing Address - Fax:276-935-2889
Practice Address - Street 1:18765 RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614
Practice Address - Country:US
Practice Address - Phone:276-935-2880
Practice Address - Fax:276-935-2889
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024089979207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10166OtherMEDICARE GROUP PTAN
VA00X385A02Medicare PIN