Provider Demographics
NPI:1578868634
Name:ALFORD, WENDY RENEE (CNA)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:RENEE
Last Name:ALFORD
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22521 N BUCKHILL RD
Mailing Address - Street 2:
Mailing Address - City:HOWEY-IN-THE-HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34737
Mailing Address - Country:US
Mailing Address - Phone:352-324-2040
Mailing Address - Fax:
Practice Address - Street 1:22521 N BUCKHILL RD
Practice Address - Street 2:
Practice Address - City:HOWEY IN THE HILLS
Practice Address - State:FL
Practice Address - Zip Code:34737-4529
Practice Address - Country:US
Practice Address - Phone:352-324-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA 199948376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
CNA 199948OtherCNA 199948