Provider Demographics
NPI:1962171793
Name:WREN, JANICA RENEE' (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:JANICA
Middle Name:RENEE'
Last Name:WREN
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 CANFIELD RD UNIT 2934
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-2888
Mailing Address - Country:US
Mailing Address - Phone:216-647-1601
Mailing Address - Fax:
Practice Address - Street 1:4073 PLEASANT VALLEY
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-2888
Practice Address - Country:US
Practice Address - Phone:216-647-1601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily