Provider Demographics
NPI:1578145488
Name:WANZEK, JANELLE LORI (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JANELLE
Middle Name:LORI
Last Name:WANZEK
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:650 S GREEN VALLEY PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-0425
Mailing Address - Country:US
Mailing Address - Phone:702-847-6252
Mailing Address - Fax:702-847-6254
Practice Address - Street 1:650 S GREEN VALLEY PKWY STE 120
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-0425
Practice Address - Country:US
Practice Address - Phone:702-847-6252
Practice Address - Fax:028-476-2547
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVPA2429363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant