Provider Demographics
NPI:1790055796
Name:ZENOR, WENDY JANE'E (LPN)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:JANE'E
Last Name:ZENOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:WENDY
Other - Middle Name:JANE'E
Other - Last Name:ZENOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1525 ROLLING HILLS LOOP
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503
Mailing Address - Country:US
Mailing Address - Phone:712-256-3163
Mailing Address - Fax:
Practice Address - Street 1:1525 ROLLING HILLS LOOP
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503
Practice Address - Country:US
Practice Address - Phone:712-256-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP54906164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse