Provider Demographics
NPI:1568208833
Name:JANOS, ALLISON C (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:C
Last Name:JANOS
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19229 MACK AVE STE 24
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-2857
Mailing Address - Country:US
Mailing Address - Phone:313-884-5522
Mailing Address - Fax:
Practice Address - Street 1:19229 MACK AVE STE 24
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-2857
Practice Address - Country:US
Practice Address - Phone:313-884-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704289589363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner