Provider Demographics
NPI:1417570359
Name:STEVENS-HILL, WYNDI M (LPN)
Entity Type:Individual
Prefix:MRS
First Name:WYNDI
Middle Name:M
Last Name:STEVENS-HILL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14934 MIDWAY RD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-8147
Mailing Address - Country:US
Mailing Address - Phone:360-970-0805
Mailing Address - Fax:
Practice Address - Street 1:4521 THOMAS JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5100
Practice Address - Country:US
Practice Address - Phone:208-454-4820
Practice Address - Fax:208-454-4859
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID53514164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse