Provider Demographics
NPI:1639310279
Name:ADER, JANET RENEE (MSN,FNP-BC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:RENEE
Last Name:ADER
Suffix:
Gender:F
Credentials:MSN,FNP-BC
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:RENEE
Other - Last Name:BOTTRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP-BC
Mailing Address - Street 1:1000 HOUGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602
Mailing Address - Country:US
Mailing Address - Phone:989-583-6800
Mailing Address - Fax:989-583-6955
Practice Address - Street 1:5421 COLONY DR N
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638
Practice Address - Country:US
Practice Address - Phone:989-790-3141
Practice Address - Fax:989-583-6955
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704215299363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI381908328-432OtherCARE SOURCE OF MICHIGAN
MI174506OtherGREAT LAKES HEALTH PLAN/UNITED HEALTHCARE
MI53837OtherHEALTH PLAN OF MICHIGAN
MN1639310279Medicaid
MI1046914OtherMCLAREN HEALTH PLAN
MI1639310279OtherMOLINA HEALTHCARE OF MICHIGAN
MN1639310279Medicaid