Provider Demographics
NPI:1851358733
Name:MCFADDEN, JANICE ANN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:ANN
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 TURNBERRY XING
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-3079
Mailing Address - Country:US
Mailing Address - Phone:440-666-3883
Mailing Address - Fax:
Practice Address - Street 1:125 TURNBERRY XING
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-3079
Practice Address - Country:US
Practice Address - Phone:440-666-3883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN203504367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH740772OtherBUCKEYE
OHP00412370OtherRAILROAD MEDICARE
OH7483578OtherAETNA
OH000000225078OtherUNISON
OH000000516000OtherANTHEM
OH0583328OtherBCMH
OH414790OtherWELLCARE
OH0254639Medicaid
OH740772OtherBUCKEYE