Provider Demographics
NPI:1639478902
Name:TERRELL, JANET MAY (CNA/RMA)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:MAY
Last Name:TERRELL
Suffix:
Gender:F
Credentials:CNA/RMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 OKEECHOBEE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-4051
Mailing Address - Country:US
Mailing Address - Phone:561-674-3875
Mailing Address - Fax:561-615-4409
Practice Address - Street 1:4715 MARGUERITA DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-3035
Practice Address - Country:US
Practice Address - Phone:561-674-3875
Practice Address - Fax:561-615-4409
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL64847374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002843200Medicaid