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Individual

MRS. AMBER LEIGH JANZEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1301 N 2ND ST, BOONEVILLE, MS 38829-1028
(662) 728-2071
(662) 728-2077
Mailing address
1301 N 2ND ST, BOONEVILLE, MS 38829-1028

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R871985
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C02394
MEDICARE GROUP NUMBER
MS
Enumeration date
09/07/2011
Last updated
09/07/2011
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