Provider Demographics
NPI:1841524345
Name:SKENADORE, JANEEN
Entity type:Individual
Prefix:
First Name:JANEEN
Middle Name:
Last Name:SKENADORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 W COLDSPRING RD
Mailing Address - Street 2:APT 19
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220
Mailing Address - Country:US
Mailing Address - Phone:414-545-2632
Mailing Address - Fax:
Practice Address - Street 1:4900 W COLDSPRING RD
Practice Address - Street 2:APT 19
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-3682
Practice Address - Country:US
Practice Address - Phone:414-545-2632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI167264-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse