Provider Demographics
NPI:1689949539
Name:NOSEK, JANICE MARIE (MS, PA-C)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:MARIE
Last Name:NOSEK
Suffix:
Gender:F
Credentials:MS, PA-C
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:747 SHALLOW RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-3016
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4863 PULASKI HWY
Practice Address - Street 2:SUITE 120
Practice Address - City:PERRYVILLE
Practice Address - State:MD
Practice Address - Zip Code:21903-1623
Practice Address - Country:US
Practice Address - Phone:410-642-9172
Practice Address - Fax:410-642-9176
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDC0004688363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant