Provider Demographics
NPI:1174978134
Name:PARMETER, JANICE
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:PARMETER
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 1:52710 LEWIS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:MI
Mailing Address - Zip Code:49067-9304
Mailing Address - Country:US
Mailing Address - Phone:269-646-9251
Mailing Address - Fax:269-646-2331
Practice Address - Street 1:52710 LEWIS LAKE RD
Practice Address - Street 2:
Practice Address - City:MARCELLUS
Practice Address - State:MI
Practice Address - Zip Code:49067-9304
Practice Address - Country:US
Practice Address - Phone:269-646-9251
Practice Address - Fax:269-646-2331
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAF750005795311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility