Provider Demographics
NPI:1639479686
Name:GEBHARDT, WENDY FORDYCE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:FORDYCE
Last Name:GEBHARDT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 FRANKLINS CHANCE CT
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-1322
Mailing Address - Country:US
Mailing Address - Phone:410-692-6478
Mailing Address - Fax:
Practice Address - Street 1:22 SOUTH GREENE STREET, DEPT.OF ORTHOPAEDICS
Practice Address - Street 2:UNIVERSITY OF MARYLAND MEDICAL CENTER
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR188680363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care