Provider Demographics
NPI:1649223892
Name:CROSS, JANET LEIGH (APRN, BC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LEIGH
Last Name:CROSS
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 SPRINGBANK LANE SUITE 106
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3198
Mailing Address - Country:US
Mailing Address - Phone:704-582-1124
Mailing Address - Fax:980-819-5798
Practice Address - Street 1:3315 SPRINGBANK LN STE 106
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3198
Practice Address - Country:US
Practice Address - Phone:704-582-1124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC099783163WP0809X
NC99783364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2809793Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE