JACQUELINE WANEZEK (NPI# 1932632353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932632353 |
| Entity Type | Individual |
| Full Name | JACQUELINE WANEZEK |
| Credential | D.D.S. |
| Practice Address |
2365 Donarski Ct Green Bay WI 54302-4329 |
| Practice Telephone | 9206217465 |
| Mailing Telephone | 9206217465 |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2365 DONARSKI CT |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54302-4329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659721371 | Carissa Marie Sawicki | Counselor | 1234 Main Street, Suite 21, 3rd Floor, Green Bay, WI 54302 | 2016-06-14 |
| 1891181459 | Shannon Rae Mullins | Registered Nurse | 2254 Imperial Ln, Green Bay, WI 54302 | 2015-04-10 |
| 1346667045 | David Howard Jadin | Dentist | 1245 Main St, Green Bay, WI 54302 | 2014-03-20 |
| 1407003577 | Abby Baumgart | Counselor | 1234-21 Main St, Green Bay, WI 54302 | 2008-08-20 |
| 1447441779 | Muller Eyecare Associates Ltd | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-08-01 |
| 1851385231 | Bornemann Nursing Home Inc | Skilled Nursing Facility | 226 Bornemann St, Green Bay, WI 54302 | 2005-08-31 |
| 1194188706 | Familia Dental Green Bay LLC | Dentist | 1931 Main St., Green Bay, WI 54302 | 2016-03-31 |
| 1255710125 | Kim Lawrence | Social Worker | 1234 Main St., St 21, 3rd Floor, Green Bay, WI 54302 | 2015-05-26 |
| 1255464533 | John Muller | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-03-14 |
| 1851622005 | Michael Andrew Larkey | Social Worker | 815 Reber St, Green Bay, WI 54302-1116 | 2010-01-27 |
| Find all providers in zip 54302 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205474905 | Nonglee Moua | Student in an Organized Health Care Education/Training Program | 345 Westplain Dr, Green Bay, WI 54303-3367 | 2019-12-13 |
| 1386138568 | Casey Gerald Deshambo | Student in an Organized Health Care Education/Training Program | 2100 Memorial Dr Apt 207, Green Bay, WI 54303-5309 | 2018-06-20 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1013531656 | Michael Tadayuki Miyamoto | Student in an Organized Health Care Education/Training Program | 2851 University Ave, Green Bay, WI 54311-5855 | 2020-05-29 |
| 1669093175 | Lacey Renee Anderson | Student in an Organized Health Care Education/Training Program | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-05-06 |
| 1184245326 | Kevin Michael Hansen | Student in an Organized Health Care Education/Training Program | 2851 University Ave, Green Bay, WI 54311-5855 | 2020-04-28 |
| 1689201832 | Ifeanyi Jeffrey Mbah | Student in an Organized Health Care Education/Training Program | 2851 University Ave, Green Bay, WI 54311-5855 | 2020-03-26 |
| 1689236531 | Heidi Marie Wennesheimer | Student in an Organized Health Care Education/Training Program | 1061 W Mason St, Green Bay, WI 54303-1858 | 2019-07-01 |
| 1942862982 | Nisa Keane Liberty | Student in an Organized Health Care Education/Training Program | 2851 University Ave, Green Bay, WI 54311-5855 | 2019-06-29 |
| 1053973123 | Kristin Nelson | Student in an Organized Health Care Education/Training Program | 2851 University Ave, Green Bay, WI 54311-5855 | 2019-06-28 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.