Provider Demographics
NPI:1639824980
Name:DUENAS, WENDY LYNN (PRSS-5102)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:LYNN
Last Name:DUENAS
Suffix:
Gender:F
Credentials:PRSS-5102
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 SUE WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1852
Mailing Address - Country:US
Mailing Address - Phone:775-741-3134
Mailing Address - Fax:
Practice Address - Street 1:900 W 1ST ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5675
Practice Address - Country:US
Practice Address - Phone:775-322-8941
Practice Address - Fax:775-322-1544
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPRSS-5102175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist