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Individual

JANETTA C PROVERBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
505 NE 87TH AVE STE 160, VANCOUVER, WA 98664-1965
(360) 514-1060
(360) 514-1065
Mailing address
9375 W 75TH ST, OVERLAND PARK, KS 66204
(913) 642-7000
(913) 642-7020

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
0426209
KS
207V00000X
Obstetrics & Gynecology Physician
Primary
MD61042142
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100193060A
KS
Enumeration date
06/23/2005
Last updated
03/11/2022
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