Provider Demographics
NPI:1942236484
Name:DU BOIS, JANET C (ARNP)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:C
Last Name:DU BOIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 45TH WAY E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-8890
Mailing Address - Country:US
Mailing Address - Phone:941-302-6001
Mailing Address - Fax:941-302-6001
Practice Address - Street 1:3110 45TH WAY E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-8890
Practice Address - Country:US
Practice Address - Phone:941-302-6001
Practice Address - Fax:941-302-6001
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2513082363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P17356Medicare UPIN