Provider Demographics
NPI:1760490932
Name:MCLEOD, JANET ELISE (RN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ELISE
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 ST. JOHN'S BLVD.
Mailing Address - Street 2:200
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1190
Mailing Address - Country:US
Mailing Address - Phone:651-747-8612
Mailing Address - Fax:651-747-8628
Practice Address - Street 1:1600 ST. JOHN'S BLVD.
Practice Address - Street 2:200
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1190
Practice Address - Country:US
Practice Address - Phone:651-747-8612
Practice Address - Fax:651-747-8628
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 077109-6163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse