Individual provider Active NPI

Janice Elaine Taylor-Conerly, RN CPNP

  • Pediatric Nurse Practitioner
  • Flint, MI
National Provider Identifier
1205928249
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704088006 Issued in MI
Practice address
806 Tuuri Place
Flint, MI 48503-2465
Phone
(810) 767-5750
Fax
(810) 591-6904
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704088006 MI Primary

Addresses

Primary practice location

806 Tuuri Place
Flint, MI 48503-2465

Mailing address

9446 Rustic Ridge Trail
Grand Blanc, MI 48439-4951
Phone (810) 603-2362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704088006MIMDPediatric Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205928249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9446 RUSTIC RIDGE TRAIL",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484394951",
            "telephone_number": "810-603-2362",
            "fax_number": "810-603-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 TUURI PLACE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032465",
            "telephone_number": "810-767-5750",
            "fax_number": "810-591-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR-CONERLY",
        "first_name": "JANICE",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "RN CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704088006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.