Provider Demographics
NPI:1356002059
Name:WENZEL, SHARI MARIE (LVN)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:MARIE
Last Name:WENZEL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:MARIE
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:3126 SPRING ST SPC 9
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-1238
Mailing Address - Country:US
Mailing Address - Phone:805-270-0509
Mailing Address - Fax:
Practice Address - Street 1:2178 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4535
Practice Address - Country:US
Practice Address - Phone:805-781-4712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN251450164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse