Provider Demographics
NPI:1760732929
Name:RANK, WENDI LYNNE (CRNP)
Entity Type:Individual
Prefix:
First Name:WENDI
Middle Name:LYNNE
Last Name:RANK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:WENDI
Other - Middle Name:LYNNE
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:2 CAPITAL WAY
Mailing Address - Street 2:SUITE 456
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2521
Mailing Address - Country:US
Mailing Address - Phone:609-588-5081
Mailing Address - Fax:
Practice Address - Street 1:2 CAPITAL WAY
Practice Address - Street 2:SUITE 456
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2521
Practice Address - Country:US
Practice Address - Phone:609-588-5081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00385500363L00000X
PASP007601363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner