Healthcare Provider Details

I. General information

NPI: 1851323604
Provider Name (Legal Business Name): KATHLEEN A JANUS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 SIX FORKS RD STE 260
RALEIGH NC
27615-5285
US

IV. Provider business mailing address

2675 WINKLER AVE STE 200
FORT MYERS FL
33901-9328
US

V. Phone/Fax

Practice location:
  • Phone: 919-846-9292
  • Fax: 919-848-3638
Mailing address:
  • Phone: 877-856-3774
  • Fax: 239-599-2612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number200721
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: