Provider Demographics
NPI:1104453331
Name:JANES, KRISTEN LEIGH (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:LEIGH
Last Name:JANES
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 FARM ROAD 2825
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75426-3348
Mailing Address - Country:US
Mailing Address - Phone:903-427-2201
Mailing Address - Fax:
Practice Address - Street 1:120 FARM ROAD 2825
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75426-3348
Practice Address - Country:US
Practice Address - Phone:903-427-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1069771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily