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Individual

JENNA WENZEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
530 E 74TH ST, NEW YORK, NY 10021
(212) 639-3969
Mailing address
530 E 74TH ST, NEW YORK, NY 10021
(212) 639-3969

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
310057
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
310057
NY
363LA2200X
Adult Health Nurse Practitioner
5008782
NC

Other

Enumeration date
08/03/2016
Last updated
07/09/2021
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