Provider Demographics
NPI:1164284097
Name:GRENTZ, JANET MICHELLE (BSN, RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MICHELLE
Last Name:GRENTZ
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 MURRAY FARM RD APT 1113
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75069-6945
Mailing Address - Country:US
Mailing Address - Phone:972-571-9386
Mailing Address - Fax:
Practice Address - Street 1:340 MURRAY FARM RD APT 1113
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TX
Practice Address - Zip Code:75069-6945
Practice Address - Country:US
Practice Address - Phone:972-571-9386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237258163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant