Provider Demographics
NPI:1205857810
Name:WOZNIAK, JANELL R (MD)
Entity Type:Individual
Prefix:
First Name:JANELL
Middle Name:R
Last Name:WOZNIAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANELL
Other - Middle Name:L
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 PENNOCK PL
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3257
Mailing Address - Country:US
Mailing Address - Phone:970-495-8800
Mailing Address - Fax:970-495-8820
Practice Address - Street 1:1025 PENNOCK PL
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3257
Practice Address - Country:US
Practice Address - Phone:970-495-8800
Practice Address - Fax:970-495-8820
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37315207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO26275821Medicaid
CO26275821Medicaid
COC804038Medicare PIN