Provider Demographics
NPI:1629703616
Name:MARKE, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MARKE
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 1:779 EASTOWNE DR APT 805
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-4149
Mailing Address - Country:US
Mailing Address - Phone:301-281-7716
Mailing Address - Fax:
Practice Address - Street 1:779 EASTOWNE DR APT 805
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-4149
Practice Address - Country:US
Practice Address - Phone:301-281-7716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2023-09-07
Deactivation Date:2023-03-10
Deactivation Code:
Reactivation Date:2023-08-15
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician