Janousek, Laresa M

Janousek, Laresa M is an individual health care provider with primary practice located at 190 E Bannock St , Boise ID 83712-6241. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Janousek, Laresa M can be contacted via phone (208) 381-2222.

Contact Information

Primary practice address
190 E Bannock St Boise ID 83712-6241
Phone: (208) 381-2222
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X NP749A Idaho

Profile Details

NPI number 1013949155
LBN Legal business name Janousek, Laresa M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Apr 8th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013949155 NPPES
Idaho Other NP749A STATE LICENSE #

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