Provider Demographics
NPI:1639412356
Name:WENZEL, MAUREEN (NP)
Entity Type:Individual
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First Name:MAUREEN
Middle Name:
Last Name:WENZEL
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-534-9550
Mailing Address - Fax:720-932-7805
Practice Address - Street 1:1515 WAZEE ST
Practice Address - Street 2:UNIT D
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1478
Practice Address - Country:US
Practice Address - Phone:303-534-9550
Practice Address - Fax:720-932-7805
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2016-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO990440363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO68730063Medicaid
CO296907YL7XMedicare PIN