Healthcare Provider Details

I. General information

NPI: 1396702544
Provider Name (Legal Business Name): JANENE ERIKA JARRETT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 09/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6113 N FRESNO ST
FRESNO CA
93710-8621
US

IV. Provider business mailing address

6113 N FRESNO ST
FRESNO CA
93710-8621
US

V. Phone/Fax

Practice location:
  • Phone: 559-431-1737
  • Fax: 559-431-1739
Mailing address:
  • Phone: 559-431-1737
  • Fax: 559-431-1739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number572076
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number14894
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number14894
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: