Provider Demographics
NPI:1205928249
Name:TAYLOR-CONERLY, JANICE ELAINE (RN CPNP)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:ELAINE
Last Name:TAYLOR-CONERLY
Suffix:
Gender:F
Credentials:RN CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9446 RUSTIC RIDGE TRAIL
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-4951
Mailing Address - Country:US
Mailing Address - Phone:810-603-2362
Mailing Address - Fax:810-603-2362
Practice Address - Street 1:806 TUURI PLACE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2465
Practice Address - Country:US
Practice Address - Phone:810-767-5750
Practice Address - Fax:810-591-6904
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704088006363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics