Healthcare Provider Details

I. General information

NPI: 1447588090
Provider Name (Legal Business Name): JANET LEE BIANCARDI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2009
Last Update Date: 03/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 E FERRELL ST
SOUTH HILL VA
23970-2102
US

IV. Provider business mailing address

PO BOX 839
SOUTH HILL VA
23970-0839
US

V. Phone/Fax

Practice location:
  • Phone: 434-447-7765
  • Fax: 434-447-4011
Mailing address:
  • Phone: 434-447-7765
  • Fax: 434-447-4011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0024169945
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberAPN001129
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: