Individual
MRS. JANET LEE MAXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP, PHD
Contact information
Practice address
315 MAIN ST S, SUITE 205, MINOT, ND 58701-3956
(701) 857-5854
(701) 857-5075
Mailing address
LEGACY HEALTH CLINIC, 1324 20TH AVE SW, MINOT, ND 58701-4040
(701) 838-6000
(701) 838-6024
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PAC0057
ND
363L00000X
Nurse Practitioner
Primary
R-16251
ND
363LF0000X
Family Nurse Practitioner
R16251
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23509
ND BLUE SHIELD
ND
Enumeration date
11/10/2006
Last updated
10/28/2021
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