Provider Demographics
NPI:1811053937
Name:STAMPS, JANICE LYNN (PT)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:LYNN
Last Name:STAMPS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6215 E FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2877
Mailing Address - Country:US
Mailing Address - Phone:812-401-5210
Mailing Address - Fax:812-401-5220
Practice Address - Street 1:6215 E FLORIDA ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2877
Practice Address - Country:US
Practice Address - Phone:812-401-5210
Practice Address - Fax:812-401-5220
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05004795A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN252940CMedicare PIN