Wagner, Janelle Joy

Wagner, Janelle Joy is an individual health care provider with primary practice located at 1760 E Ken Pratt Blvd Ste 301&302 , Longmont CO 80504-5311. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wagner, Janelle Joy can be contacted via phone (303) 684-1900.

Contact Information

Primary practice address
1760 E Ken Pratt Blvd Ste 301&302 Longmont CO 80504-5311
Phone: (303) 684-1900
Fax: (303) 684-1925
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X NP10340 Colorado

Profile Details

NPI number 1801115340
LBN Legal business name Wagner, Janelle Joy
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2010
Last updated May 15th, 2023 - about last year

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 1801115340 NPPES
Colorado MEDICAID 61605271

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