Healthcare Provider Details

I. General information

NPI: 1093875684
Provider Name (Legal Business Name): JANET LAUER CANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8116 GOOD LUCK RD
LANHAM MD
20706-3502
US

IV. Provider business mailing address

8116 GOOD LUCK RD
LANHAM MD
20706-3502
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-8130
  • Fax: 607-324-7615
Mailing address:
  • Phone: 301-552-8130
  • Fax: 607-324-7615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN38162
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR059004
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: