Provider Demographics
NPI:1013418060
Name:CARPENTER, WENDY A
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:A
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:A
Other - Last Name:FRANDINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE
Mailing Address - Street 1:1334 REESLING DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4245
Mailing Address - Country:US
Mailing Address - Phone:972-342-0512
Mailing Address - Fax:
Practice Address - Street 1:1334 REESLING DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4245
Practice Address - Country:US
Practice Address - Phone:972-342-0512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX164X0000X01X164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse