Provider Demographics
NPI:1700491214
Name:THEBERT, JANICE
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:THEBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8207 TOWNSHIP ROAD 207
Mailing Address - Street 2:
Mailing Address - City:DE GRAFF
Mailing Address - State:OH
Mailing Address - Zip Code:43318-9723
Mailing Address - Country:US
Mailing Address - Phone:937-214-0584
Mailing Address - Fax:
Practice Address - Street 1:8207 TOWNSHIP ROAD 207
Practice Address - Street 2:
Practice Address - City:DE GRAFF
Practice Address - State:OH
Practice Address - Zip Code:43318-9723
Practice Address - Country:US
Practice Address - Phone:937-214-0584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle