Provider Demographics
NPI:1376198762
Name:PRINTZ, JANELLE RENEA (AGACNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JANELLE
Middle Name:RENEA
Last Name:PRINTZ
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22357 COUNTY ROAD 37
Mailing Address - Street 2:
Mailing Address - City:LA SALLE
Mailing Address - State:CO
Mailing Address - Zip Code:80645-8709
Mailing Address - Country:US
Mailing Address - Phone:970-405-1242
Mailing Address - Fax:
Practice Address - Street 1:340 EXEMPLA CIR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3384
Practice Address - Country:US
Practice Address - Phone:303-673-1944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-03
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013337363L00000X
COAPN.0994848-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner