Provider Demographics
NPI:1396702544
Name:JARRETT, JANENE ERIKA (NP)
Entity type:Individual
Prefix:MS
First Name:JANENE
Middle Name:ERIKA
Last Name:JARRETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6113 N FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8621
Mailing Address - Country:US
Mailing Address - Phone:559-431-1737
Mailing Address - Fax:559-431-1739
Practice Address - Street 1:6113 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8621
Practice Address - Country:US
Practice Address - Phone:559-431-1737
Practice Address - Fax:559-431-1739
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA572076363LX0001X
CA14894363LX0001X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q38137Medicare UPIN