Provider Demographics
NPI:1407392749
Name:GERARD, WENDY DANIELLE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:DANIELLE
Last Name:GERARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 HARRISON AVE
Mailing Address - Street 2:SUITE 18
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3356
Mailing Address - Country:US
Mailing Address - Phone:304-636-8422
Mailing Address - Fax:304-696-8058
Practice Address - Street 1:1513 HARRISON AVE
Practice Address - Street 2:SUITE 18
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3356
Practice Address - Country:US
Practice Address - Phone:304-636-8422
Practice Address - Fax:304-696-8058
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN81126NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily