Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jennifer Michelle Mazanek

Individual provider Nurse Practitioner · NPI 1922951219

Jennifer Michelle Mazanek is a Nurse Practitioner in Centralia, Illinois. Qualified in 2025, 1 year ago. Licensed in Illinois.

Years since qualifying
1
Licensed in
IL
In the registry since
2026

Practice location Address checks out

1003 E McCord St
Centralia, IL 62801-3345
Phone: (618) 436-6633
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209035018 (IL)

Record details

NPI number1922951219
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 17, 2026
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Centralia