Healthcare Provider Details

I. General information

NPI: 1114305133
Provider Name (Legal Business Name): JENICA LYNN WESSELS HARWOOD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 NW FIELDING RD
TOPEKA KS
66618-2651
US

IV. Provider business mailing address

4505 NW FIELDING RD
TOPEKA KS
66618-2651
US

V. Phone/Fax

Practice location:
  • Phone: 785-270-0047
  • Fax: 785-270-0032
Mailing address:
  • Phone: 785-270-0047
  • Fax: 785-270-0032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-39114
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: