Provider Demographics
NPI:1821119751
Name:MARJENHOFF, JANA LEE (DO)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:LEE
Last Name:MARJENHOFF
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 LAKEVIEW CIR SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2226
Mailing Address - Country:US
Mailing Address - Phone:505-301-3145
Mailing Address - Fax:
Practice Address - Street 1:632 LAKEVIEW CIR SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-2226
Practice Address - Country:US
Practice Address - Phone:505-301-3145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1590-10207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine