Healthcare Provider Details

I. General information

NPI: 1932319506
Provider Name (Legal Business Name): JANICE PATRICE THORNTON ADMINISTRATOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 PERSON ST
OXFORD NC
27565-3732
US

IV. Provider business mailing address

308 PERSON ST
OXFORD NC
27565-3732
US

V. Phone/Fax

Practice location:
  • Phone: 919-693-7656
  • Fax:
Mailing address:
  • Phone: 919-693-7656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License NumberFCL-039-006
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: