Healthcare Provider Details

I. General information

NPI: 1922300904
Provider Name (Legal Business Name): JANET R CUTLER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2010
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 E 12TH ST
WASHINGTON NC
27889-3409
US

IV. Provider business mailing address

608 E 12TH ST
WASHINGTON NC
27889-3409
US

V. Phone/Fax

Practice location:
  • Phone: 252-948-3200
  • Fax: 252-948-3202
Mailing address:
  • Phone: 252-946-1573
  • Fax: 252-946-1316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5004978
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5004978
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: