Provider Demographics
NPI:1215575253
Name:PARTIDA, WENDY ELAYNE
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ELAYNE
Last Name:PARTIDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:ELAYNE
Other - Last Name:FORMALEJO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:155 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89433-7754
Mailing Address - Country:US
Mailing Address - Phone:775-440-9703
Mailing Address - Fax:
Practice Address - Street 1:1855 SELMI DR APT G159
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-4767
Practice Address - Country:US
Practice Address - Phone:775-440-9703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide