Provider Demographics
NPI:1326045980
Name:MERULLI, WENDY S (CRNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:S
Last Name:MERULLI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2530
Mailing Address - Country:US
Mailing Address - Phone:724-728-5995
Mailing Address - Fax:724-728-6705
Practice Address - Street 1:1201 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2530
Practice Address - Country:US
Practice Address - Phone:724-728-5995
Practice Address - Fax:724-728-6705
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP006409M363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP09103Medicare UPIN
PA038935Medicare ID - Type Unspecified