Laresa M Janousek
Nurse Practitioner - Neonatal
190 E Bannock St
Boise
, Idaho 83712-6241
Laresa M Janousek
Nurse Practitioner - Neonatal
190 E Bannock St
Boise
, Idaho 83712-6241
(208) 381-2222
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About
Features
Specialties
- Nurse Practitioner - Neonatal
Languages spoken
- English
Location
First Address
- Laresa M Janousek
- 190 E Bannock St
- Boise, ID
- Zip : 83712
- Phone : (208) 381-2222
Second Address
- Laresa M Janousek
- 190 E Bannock St
- Boise, ID
- Zip : 83712-6241
- Phone : (208) 381-2222
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LN0000X | Nurse Practitioner - Neonatal | NP749A | ID |
National Provider Identifier
| NPI | 1013949155 |
|---|---|
| Provider Name | Laresa M Janousek |
| First Address | Boise, ID 83712 |
| Second Address | Boise, ID 83712-6241 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/07/2006 |
| Last Update Date | 08/04/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| NP749A | STATE LICENSE # (01) | ID |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.