Individual
MATTHEW JAMES JANEZIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
400 E 3RD ST, DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 783-8364
Mailing address
1615 MAPLE LN, ASHLAND, WI 54806-3626
(715) 685-5500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
8200
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
8200
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386981777
—
MI
05
—
1386981777
—
MN
05
—
1386981777
—
WI
Enumeration date
01/07/2013
Last updated
01/26/2023
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