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General NPI Number Information
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NPI Number | 1700199122
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Entity Type | Individual
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Provider Name | ALBERTA JANOUSEK PA
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Gender | Female
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 2855 CAPITAL AVE SW
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City | BATTLE CREEK
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State | MI
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Zip | 49015-6105
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Country | US
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Telephone | 269-969-0885
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Fax | 269-964-0885
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Provider Business Mailing Address
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Address Line | 1999 BRIGHTON LN
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City | PORTAGE
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State | MI
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Zip | 49024-2586
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Country | US
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Telephone | 269-329-0740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SW0102X
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Taxonomy Name | Women's Health Clinical Nurse Specialist
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License Number | 363LF0000X
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License Number State | MI
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