Provider Demographics
NPI:1528351392
Name:RAFFERTY, JANET P (RN MS)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:P
Last Name:RAFFERTY
Suffix:
Gender:F
Credentials:RN MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 S LUDLOW ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402
Mailing Address - Country:US
Mailing Address - Phone:937-208-8816
Mailing Address - Fax:937-208-8828
Practice Address - Street 1:725 LUDLOW ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402
Practice Address - Country:US
Practice Address - Phone:937-208-8816
Practice Address - Fax:937-208-8828
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.183238163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN. 183238OtherRN