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NPI Code Detail

MEDICARE: MRS. JANICE LEE JAMES RN, DNP, FNP-C

MEDICARE: MRS. JANICE LEE JAMES RN, DNP, FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerR123587-4MN

General Provider Information

NPI Number : 1407187511
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANICE LEE JAMES RN, DNP, FNP-C
Provider Business Mailing Address
First Line : 1401 HICKORY TRL
Second Line :
City : WHITE BEAR LAKE
State : MN
Zip : 55110-2272
Country : US
Telephone Number : 651-426-0342
Fax Number :
Provider Business Practice Location Address
First Line : 967 LAKE ST S
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-2616
Country : US
Telephone Number : 651-464-1113
Fax Number : 651-464-0853
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2010
Last Update Date : 03/17/2018

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