Provider Demographics
NPI:1720198302
Name:CONSTANTINE, JANEEN E (NP)
Entity Type:Individual
Prefix:MRS
First Name:JANEEN
Middle Name:E
Last Name:CONSTANTINE
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 1:106 IRVING ST NW
Mailing Address - Street 2:STE 2700N
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:202-723-5524
Mailing Address - Fax:202-291-0512
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:STE 2700N
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:202-723-5524
Practice Address - Fax:202-291-0512
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN43233363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC409629OtherMEDICARE GROUP
MD001787C29OtherINDIV MEDICARE
MD066MOtherMEDICARE GROUP
MDCD0361OtherRAILROAD MEDICARE GROUP
MD066MOtherMEDICARE GROUP