Provider Demographics
NPI:1457798340
Name:VALENZUELA, JENELL LYNN (APNP)
Entity Type:Individual
Prefix:MRS
First Name:JENELL
Middle Name:LYNN
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 VILLAGE WALK LN
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53038-9462
Mailing Address - Country:US
Mailing Address - Phone:920-542-3010
Mailing Address - Fax:
Practice Address - Street 1:480 VILLAGE WALK LN
Practice Address - Street 2:
Practice Address - City:JOHNSON CREEK
Practice Address - State:WI
Practice Address - Zip Code:53038-9462
Practice Address - Country:US
Practice Address - Phone:920-542-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13790-33363LF0000X
WI186313-30163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome Health