Provider Demographics
NPI:1730731811
Name:MCILROY, JANET L
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:MCILROY
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 1:644 CAMELLIA TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32266-3238
Mailing Address - Country:US
Mailing Address - Phone:904-249-0261
Mailing Address - Fax:
Practice Address - Street 1:644 CAMELLIA TERRACE DR
Practice Address - Street 2:
Practice Address - City:NEPTUNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32266-3238
Practice Address - Country:US
Practice Address - Phone:904-249-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula