Provider Demographics
NPI:1497445662
Name:WENDT, CHRISTINA ELAINE (APRN PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ELAINE
Last Name:WENDT
Suffix:
Gender:F
Credentials:APRN PMHNP
Other - Prefix:
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Mailing Address - Street 1:608 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:MO
Mailing Address - Zip Code:63448-1311
Mailing Address - Country:US
Mailing Address - Phone:660-216-7520
Mailing Address - Fax:
Practice Address - Street 1:927 BROADWAY ST STE 331
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-2721
Practice Address - Country:US
Practice Address - Phone:217-224-4453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209.027352363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health