Provider Demographics
NPI:1760157655
Name:WENDT, COURTNEY MAUREEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:MAUREEN
Last Name:WENDT
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-1886
Mailing Address - Fax:
Practice Address - Street 1:8075 N SHADELAND AVE STE 330
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2694
Practice Address - Country:US
Practice Address - Phone:317-355-7220
Practice Address - Fax:317-355-9672
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71011424A363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
INQ00369292OtherRAILROAD MEDICARE