Provider Demographics
NPI:1174170989
Name:KILIAN, JANET DIANE
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:DIANE
Last Name:KILIAN
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 1:1 LAS OLAS CIR APT 1110
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1637
Mailing Address - Country:US
Mailing Address - Phone:954-522-0403
Mailing Address - Fax:
Practice Address - Street 1:1 LAS OLAS CIR APT 1110
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1637
Practice Address - Country:US
Practice Address - Phone:954-522-0403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider