Provider Demographics
NPI:1811903479
Name:BRENIZER, JANELLE D (CNA)
Entity type:Individual
Prefix:MISS
First Name:JANELLE
Middle Name:D
Last Name:BRENIZER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 CAMELOT LN LOT 100
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54868-8624
Mailing Address - Country:US
Mailing Address - Phone:715-736-7055
Mailing Address - Fax:
Practice Address - Street 1:32 CAMELOT LN LOT 100
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868-8624
Practice Address - Country:US
Practice Address - Phone:715-736-7055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI227974374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide