Provider Demographics
NPI:1396405551
Name:WENZEL, MEGAN JENNIFER (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JENNIFER
Last Name:WENZEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7897 SE DELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-8121
Mailing Address - Country:US
Mailing Address - Phone:816-671-1161
Mailing Address - Fax:
Practice Address - Street 1:2518 1/2 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2751
Practice Address - Country:US
Practice Address - Phone:816-617-1161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20100230181835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist