Provider Demographics
NPI:1689607970
Name:ADAMS, JANET K (NP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:K
Last Name:ADAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9045 US HIGHWAY 31
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-1804
Mailing Address - Country:US
Mailing Address - Phone:269-473-2222
Mailing Address - Fax:269-473-6880
Practice Address - Street 1:9045 US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-1633
Practice Address - Country:US
Practice Address - Phone:269-473-2222
Practice Address - Fax:269-473-6880
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704206210363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704206210OtherLISENCE
MIMG0941220OtherDEA