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NPI Code Detail

MEDICARE: JENNY WOELK

MEDICARE:   JENNY  WOELK
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
1133NN1002XNutrition Education NutritionistNS12001423AZ

General Provider Information

NPI Number : 1639622434
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY WOELK
Provider Business Mailing Address
First Line : 2757 S PEWTER DR
Second Line : 102
City : GILBERT
State : AZ
Zip : 85295-1282
Country : US
Telephone Number : 480-684-0781
Fax Number :
Provider Business Practice Location Address
First Line : 2757 S PEWTER DR
Second Line : 102
City : GILBERT
State : AZ
Zip : 85295-1282
Country : US
Telephone Number : 480-684-0781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2016
Last Update Date : 07/27/2016

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Directions to “ JENNY WOELK ” Practice Location

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