Provider Demographics
NPI:1760806871
Name:HUMPHREY, JANET NICOLE (LPN)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:NICOLE
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39121 PRENTISS ST APT 201
Mailing Address - Street 2:
Mailing Address - City:HARRISON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48045-6042
Mailing Address - Country:US
Mailing Address - Phone:586-596-9071
Mailing Address - Fax:
Practice Address - Street 1:39121 PRENTISS ST APT 201
Practice Address - Street 2:
Practice Address - City:HARRISON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48045-6042
Practice Address - Country:US
Practice Address - Phone:586-596-9071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health