Provider Demographics
NPI:1093410151
Name:VALDETERO, WENDY LEE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:LEE
Last Name:VALDETERO
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 1:501 SAUNDERS AVE
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-7522
Mailing Address - Country:US
Mailing Address - Phone:903-579-9800
Mailing Address - Fax:903-592-5988
Practice Address - Street 1:501 SAUNDERS AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-7522
Practice Address - Country:US
Practice Address - Phone:903-579-9800
Practice Address - Fax:903-592-5988
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily