Provider Demographics
NPI:1447233028
Name:FUCHS, JANELLA F (CFNP)
Entity Type:Individual
Prefix:
First Name:JANELLA
Middle Name:F
Last Name:FUCHS
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-1114
Mailing Address - Country:US
Mailing Address - Phone:952-442-7015
Mailing Address - Fax:952-442-7016
Practice Address - Street 1:851 MARKETPLACE DR
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1548
Practice Address - Country:US
Practice Address - Phone:952-442-1969
Practice Address - Fax:952-442-7016
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0500003174Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
MNP69462Medicare UPIN