Doctor Name: | WENDY K JAMROS |
NPI Number: | 1366408551 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RNP |
License Number: | 4704182384 |
Business Practice Address: | 12124 W Lakeshore Dr Brimley, MI - 497159319 |
Business Phone Number: | 9062483241 |
Business Fax Number: | 9062483376 |
Mailing Address: | 12124 W Lakeshore Dr, Po Box 138 BRIMLEY |
State: | MI |
Postal Code: | 497159319 |
Phone Number: | 9062483241 |
Fax Number: | 9062483376 |
NPI Enumeration Date: | 04/25/2006 |
NPI Last Update Date: | 11/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704182384 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |