Provider Demographics
NPI:1548993629
Name:HENKEL, JANNA JENIECE
Entity type:Individual
Prefix:
First Name:JANNA
Middle Name:JENIECE
Last Name:HENKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 W CHEROKEE AVE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-4725
Mailing Address - Country:US
Mailing Address - Phone:956-666-7854
Mailing Address - Fax:
Practice Address - Street 1:114 W CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-4725
Practice Address - Country:US
Practice Address - Phone:956-666-1854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant