Provider Demographics
NPI:1730123399
Name:BRIAN, WENDY L (CRNP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:BRIAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1002
Mailing Address - Country:US
Mailing Address - Phone:215-368-1900
Mailing Address - Fax:215-368-8772
Practice Address - Street 1:1970 N BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1002
Practice Address - Country:US
Practice Address - Phone:215-368-1900
Practice Address - Fax:215-368-8772
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP003071G363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA500024701OtherRRM
PA500024701OtherRRM
PA001684NFEMedicare PIN