Healthcare Provider Details

I. General information

NPI: 1326223397
Provider Name (Legal Business Name): JANICE F CHEVRETTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANICE F. CHEVRETTE MSN, RN, NP-C, CWOCN

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 12/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 JACKSON ST - MS 11105A HEALTHPARTNERS REGIONS SPECIALTY CLINICS
ST. PAUL MN
55101-2502
US

IV. Provider business mailing address

8170 33RD AVE S MS21110Q
MINNEAPOLIS MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 651-254-3456
  • Fax: 651-254-3456
Mailing address:
  • Phone: 952-883-5375
  • Fax: 651-254-3456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0807332
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: