Individual
AUDREY JANTZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
60365-20
WI
2084N0400X
Neurology Physician
66542191205
UT
Other
Enumeration date
01/17/2008
Last updated
08/20/2021
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