Provider Demographics
NPI:1174682199
Name:BIDDLE, WENDY L (CFNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:BIDDLE
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 KEMPSVILLE RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3800
Mailing Address - Country:US
Mailing Address - Phone:757-466-0165
Mailing Address - Fax:757-466-7296
Practice Address - Street 1:885 KEMPSVILLE RD
Practice Address - Street 2:SUITE 114
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3800
Practice Address - Country:US
Practice Address - Phone:757-466-0165
Practice Address - Fax:757-466-7296
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001079580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA38457POtherOPTIMA
NC7003657Medicaid
VA7788801Medicaid
VAS27413Medicare UPIN