Provider Demographics
NPI:1659615318
Name:PEOPLES, WENDY
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:PEOPLES
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 1:481 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:OH
Mailing Address - Zip Code:45634-8735
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:481 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:OH
Practice Address - Zip Code:45634-8735
Practice Address - Country:US
Practice Address - Phone:740-855-4167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN099690164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse