MEDICARE: RACHEL MARIE JANOWSKI NP

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	6309-33	WI
2	363L00000X	Nurse Practitioner	6309-33	WI

General Provider Information

NPI Number	:	1639564354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL MARIE JANOWSKI NP

Provider Business Mailing Address
First Line	:	1035 KEPLER DR
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54311-8320
Country	:	US
Telephone Number	:	920-490-9046
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 HOLMGREN WAY
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54304-5224
Country	:	US
Telephone Number	:	920-288-8377
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2015
Last Update Date	:	10/10/2024

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