Provider Demographics
NPI:1619696788
Name:JANVIER, MYRNA JOSEPH (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MYRNA
Middle Name:JOSEPH
Last Name:JANVIER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:MYRNA
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:94 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3146
Mailing Address - Country:US
Mailing Address - Phone:617-784-8731
Mailing Address - Fax:
Practice Address - Street 1:94 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3146
Practice Address - Country:US
Practice Address - Phone:617-784-8731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA277680363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health