Jacqueline Nicole Wenzel, MSN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5016273 Issued in NC

Practice address

602 E Academy St Ste 205
Fuquay Varina, NC 27526-2382

Phone

(919) 635-6202

NPI assigned

May 12, 2020

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Magnolia Behavioral Health, PLLC

  dba Magnolia Psychiatry and Mental Wellness

  • Prevention Professional
  • Fuquay Varina, NC
  • NPI 1245013770

  Registered Nurse

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1427670413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 E ACADEMY ST STE 205",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262382",
            "telephone_number": "919-635-6202",
            "fax_number": "919-289-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E ACADEMY ST STE 205",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262382",
            "telephone_number": "919-635-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENZEL",
        "first_name": "JACQUELINE",
        "middle_name": "NICOLE",
        "credential": "MSN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5016273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSURE",
            "identifier": "5016273",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Webb
• Nathaniel Weber, D.O.
• Marisa Wedlock
• Georgia Macedo Weld, DDS, MS
• Bailey Wells, PA-C
• Devon Allyse Westbo
• Cheneyra White
• Laura White
• Jefferson Draughn Whitehead Jr., DDS
• Wholeu LLC

• Psychiatric/Mental Health Nurse Practitioner in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.