Provider Demographics
NPI:1750452280
Name:BUZZARD, WENDY WAKEFIELD (ANP, WHCNP, BC)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:WAKEFIELD
Last Name:BUZZARD
Suffix:
Gender:F
Credentials:ANP, WHCNP, BC
Other - Prefix:MISS
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:BUZZARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:393 FERNVALE COURT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5763
Mailing Address - Country:US
Mailing Address - Phone:931-551-5172
Mailing Address - Fax:
Practice Address - Street 1:650 JOEL DRIVE
Practice Address - Street 2:BACH
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223
Practice Address - Country:US
Practice Address - Phone:270-798-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12355363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health