Healthcare Provider Details

I. General information

NPI: 1891134292
Provider Name (Legal Business Name): JANET MIJERE APRN FNP BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 07/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 KING FARM BLVD SUITE 600
ROCKVILLE MD
20850-1136
US

IV. Provider business mailing address

1704 PALMETTO DR
MITCHELLVILLE MD
20721
US

V. Phone/Fax

Practice location:
  • Phone: 410-302-8596
  • Fax:
Mailing address:
  • Phone: 240-764-6716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR145996
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN960502
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: