Provider Demographics
NPI:1619098084
Name:MCMAHON, JANICE CAROL (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:CAROL
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 PLEASANT DR
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-4668
Mailing Address - Country:US
Mailing Address - Phone:856-327-4028
Mailing Address - Fax:
Practice Address - Street 1:1525 PLEASANT DR
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-4668
Practice Address - Country:US
Practice Address - Phone:856-327-4028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP01798900164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse