Provider Demographics
NPI:1831837558
Name:LAND, JANELLE M (RN)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:M
Last Name:LAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-0727
Mailing Address - Country:US
Mailing Address - Phone:248-981-6413
Mailing Address - Fax:
Practice Address - Street 1:900 N CASS LAKE RD APT 117
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2385
Practice Address - Country:US
Practice Address - Phone:248-499-3453
Practice Address - Fax:888-789-7377
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide