Provider Demographics
NPI:1184886079
Name:FANT, JANET M (BS PSC)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:M
Last Name:FANT
Suffix:
Gender:F
Credentials:BS PSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5436 W MARY INGLES HWY
Mailing Address - Street 2:
Mailing Address - City:FOSTER
Mailing Address - State:KY
Mailing Address - Zip Code:41043
Mailing Address - Country:US
Mailing Address - Phone:859-322-8662
Mailing Address - Fax:
Practice Address - Street 1:5436 MARY INGLES HWY W
Practice Address - Street 2:
Practice Address - City:FOSTER
Practice Address - State:KY
Practice Address - Zip Code:41043-9440
Practice Address - Country:US
Practice Address - Phone:859-322-8662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator