Provider Demographics
NPI:1568834919
Name:OSMUN, WENDY (HAD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:OSMUN
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7602 SAINT GEORGE BLVD
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-1967
Mailing Address - Country:US
Mailing Address - Phone:317-919-1895
Mailing Address - Fax:
Practice Address - Street 1:5620 CRAWFORDSVILLE RD STE Q
Practice Address - Street 2:
Practice Address - City:SPEEDWAY
Practice Address - State:IN
Practice Address - Zip Code:46224-3726
Practice Address - Country:US
Practice Address - Phone:317-388-8144
Practice Address - Fax:317-388-8160
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001453A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist