Provider Demographics
NPI:1023709086
Name:MICHAELIS, JANET GRAY (RN)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:GRAY
Last Name:MICHAELIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 VINE ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2928
Mailing Address - Country:US
Mailing Address - Phone:937-361-4148
Mailing Address - Fax:
Practice Address - Street 1:61 VINE ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2928
Practice Address - Country:US
Practice Address - Phone:937-361-4148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH135296163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse