Provider Demographics
NPI:1407195126
Name:NOLES, WENDY A (APRN)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:A
Last Name:NOLES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:A
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7145 E VIRGINIA ST STE 2000
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-9147
Mailing Address - Country:US
Mailing Address - Phone:812-962-7894
Mailing Address - Fax:812-476-6162
Practice Address - Street 1:1048 ASHLEY ST STE 102
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-2449
Practice Address - Country:US
Practice Address - Phone:502-352-2530
Practice Address - Fax:859-447-8287
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007862363L00000X, 363LF0000X
IN71007063A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201142320Medicaid
KY7100245480Medicaid
CS1807800147OtherCARESOURCE ID
4901143OtherAETNA PIN