Provider Demographics
NPI:1841269537
Name:CORSON STANTON, JANET LOUISE (RN,FNP-C)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:LOUISE
Last Name:CORSON STANTON
Suffix:
Gender:F
Credentials:RN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 BRIARCLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-6317
Mailing Address - Country:US
Mailing Address - Phone:208-524-1095
Mailing Address - Fax:208-525-7063
Practice Address - Street 1:254 E ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83402-3527
Practice Address - Country:US
Practice Address - Phone:208-522-0310
Practice Address - Fax:208-525-7063
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-658A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily