Individual
JANIS J WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
66 N 6TH ST, POMEROY, WA 99347-9705
(509) 843-1591
(509) 843-1234
Mailing address
1808 WHEATLANDS AVE, LEWISTON, ID 83501-9407
(309) 252-1084
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209001099
IL
363L00000X
Nurse Practitioner
AP60594743
WA
363LP2300X
Primary Care Nurse Practitioner
Primary
56229
ID
Other
Enumeration date
08/31/2005
Last updated
06/21/2023
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