Provider Demographics
NPI:1033255252
Name:SHROPSHIRE-ATKINS, WENDY YVONNE (PA-C)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:YVONNE
Last Name:SHROPSHIRE-ATKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 S 17TH ST
Mailing Address - Street 2:SUITE 130-A
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6662
Mailing Address - Country:US
Mailing Address - Phone:910-790-7840
Mailing Address - Fax:910-790-7828
Practice Address - Street 1:1911 S 17TH ST
Practice Address - Street 2:SUITE 130A
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6662
Practice Address - Country:US
Practice Address - Phone:910-790-7840
Practice Address - Fax:910-790-7828
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001000036207Q00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP04210Medicare UPIN
NC2763833Medicare ID - Type UnspecifiedMEDICARE