Provider Demographics
NPI:1427910306
Name:MASON, JANET JENEBA
Entity type:Individual
Prefix:MISS
First Name:JANET
Middle Name:JENEBA
Last Name:MASON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 10TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-3101
Mailing Address - Country:US
Mailing Address - Phone:386-315-1170
Mailing Address - Fax:
Practice Address - Street 1:2750 MAIN AVE
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6841
Practice Address - Country:US
Practice Address - Phone:386-315-1170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-29
Last Update Date:2025-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND81021251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care