Provider Demographics
NPI:1972198158
Name:JANOSSY, MICHELLE M (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:M
Last Name:JANOSSY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:GREEN CV SPGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-2721
Mailing Address - Country:US
Mailing Address - Phone:904-814-0805
Mailing Address - Fax:
Practice Address - Street 1:306 HARRISON ST
Practice Address - Street 2:
Practice Address - City:GREEN CV SPGS
Practice Address - State:FL
Practice Address - Zip Code:32043-2721
Practice Address - Country:US
Practice Address - Phone:904-814-0805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011005363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health