Provider Demographics
NPI:1639210032
Name:JANZEN, NICOLETTE KRIJGERS (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLETTE
Middle Name:KRIJGERS
Last Name:JANZEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11740 DEL SUR AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-6019
Mailing Address - Country:US
Mailing Address - Phone:702-575-0720
Mailing Address - Fax:
Practice Address - Street 1:653 N TOWN CENTER DR
Practice Address - Street 2:SUITE 114
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0514
Practice Address - Country:US
Practice Address - Phone:702-369-4999
Practice Address - Fax:702-369-2993
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM17922088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology