Provider Demographics
NPI:1578264206
Name:DAVENPORT, WENDY ROCHETT
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ROCHETT
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 SE 39TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73129-6803
Mailing Address - Country:US
Mailing Address - Phone:918-378-2191
Mailing Address - Fax:
Practice Address - Street 1:7101 NW EXPRESSWAY STE 325
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-1594
Practice Address - Country:US
Practice Address - Phone:405-943-0094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management