Provider Demographics
NPI:1073236527
Name:PACE, WENDEE NICOLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:WENDEE
Middle Name:NICOLE
Last Name:PACE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 MINERAL ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-3814
Mailing Address - Country:US
Mailing Address - Phone:423-608-0224
Mailing Address - Fax:
Practice Address - Street 1:307 MINERAL ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-3814
Practice Address - Country:US
Practice Address - Phone:423-608-0224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000030990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily