Provider Demographics
NPI:1821107517
Name:HILL, WENDY JENSEN (MSNP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:JENSEN
Last Name:HILL
Suffix:
Gender:F
Credentials:MSNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 PRE EMPTION RD
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-9549
Mailing Address - Country:US
Mailing Address - Phone:315-536-0008
Mailing Address - Fax:315-536-4107
Practice Address - Street 1:1930 PRE EMPTION RD
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-9641
Practice Address - Country:US
Practice Address - Phone:315-536-7725
Practice Address - Fax:315-536-4107
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF301653-A363LA2200X
NYF381018-P363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Not Answered363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF301653-AOtherADULT NP LIC #
NY16-1514207OtherEMPLOYEE ID
NY01710856Medicaid
NYF381018-POtherPED NP LIC #
J40003162OtherJ40003162
J40003162OtherJ40003162
NY16-1514207OtherEMPLOYEE ID
NYS29820Medicare UPIN