Provider Demographics
NPI:1467829036
Name:FLORIO, WENDI LEE (CRNP)
Entity Type:Individual
Prefix:
First Name:WENDI
Middle Name:LEE
Last Name:FLORIO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:WENDI
Other - Middle Name:LEE
Other - Last Name:TRABILSY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:121 WATER RUN ST
Mailing Address - Street 2:
Mailing Address - City:TANEYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21787-2365
Mailing Address - Country:US
Mailing Address - Phone:410-908-2429
Mailing Address - Fax:
Practice Address - Street 1:217 BROADWAY
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-2503
Practice Address - Country:US
Practice Address - Phone:717-632-3911
Practice Address - Fax:717-632-9254
Is Sole Proprietor?:No
Enumeration Date:2015-08-30
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018209363L00000X, 363LP0200X
MDR190055363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD115364100Medicaid