Provider Demographics
NPI:1366575904
Name:MAIDES, JANIE M (RN)
Entity type:Individual
Prefix:MS
First Name:JANIE
Middle Name:M
Last Name:MAIDES
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 1:5848 HWY 58 S
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28555-9521
Mailing Address - Country:US
Mailing Address - Phone:910-743-5901
Mailing Address - Fax:
Practice Address - Street 1:215 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6333
Practice Address - Country:US
Practice Address - Phone:910-353-5118
Practice Address - Fax:910-577-1338
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC146411163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse