Provider Demographics
NPI:1871513069
Name:CALHOUN, JANET M (ANP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:COZAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN CPNP
Mailing Address - Street 1:3050 TIMBERLINE DR
Mailing Address - Street 2:JPS-GRAPEVINE-COLLEYVILLE ISD SBHC
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-5998
Mailing Address - Country:US
Mailing Address - Phone:817-251-5752
Mailing Address - Fax:
Practice Address - Street 1:1500 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4917
Practice Address - Country:US
Practice Address - Phone:817-921-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX439058363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044388903Medicaid
TXP19671Medicare UPIN
TX044388903Medicaid