Provider Demographics
NPI:1922281245
Name:HUSMAN, JANICE GAIL (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:GAIL
Last Name:HUSMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:GAIL
Other - Last Name:CAPLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:830 SCENIC DR
Mailing Address - Street 2:BLDG 3
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350
Mailing Address - Country:US
Mailing Address - Phone:209-558-8833
Mailing Address - Fax:209-558-8315
Practice Address - Street 1:830 SCENIC DR
Practice Address - Street 2:BLDG 3
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350
Practice Address - Country:US
Practice Address - Phone:209-558-8833
Practice Address - Fax:209-558-8315
Is Sole Proprietor?:No
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN358062163W00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse