MEDICARE: JANKE FIT HEALTH AND WELLNESS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1013507326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JANKE FIT HEALTH AND WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	2850 GULF FWY
Second Line	:
City	:	LA MARQUE
State	:	TX
Zip	:	77568-4902
Country	:	US
Telephone Number	:	409-443-9822
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 GULF FWY
Second Line	:
City	:	LA MARQUE
State	:	TX
Zip	:	77568-4902
Country	:	US
Telephone Number	:	409-443-9822
Fax Number	:

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	CRYSTAL JANKE
Credential	:	FNP
Telephone Number	:	409-500-2627

Provider Enumeration Date	:	01/20/2021
Last Update Date	:	01/20/2021

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