Healthcare Provider Details

I. General information

NPI: 1720341423
Provider Name (Legal Business Name): JANELLE J LEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANELLE J PLAVCHAN MD

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W5282 AMY AVE
APPLETON WI
54915-7233
US

IV. Provider business mailing address

3 NEENAH CTR
NEENAH WI
54956-3070
US

V. Phone/Fax

Practice location:
  • Phone: 920-358-1900
  • Fax: 920-358-1993
Mailing address:
  • Phone: 920-830-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number77896-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: