Provider Demographics
NPI:1821784067
Name:WENDT, ELIZABETH O (FNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:O
Last Name:WENDT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150457 COUNTY RD N
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-2932
Mailing Address - Country:US
Mailing Address - Phone:715-551-9705
Mailing Address - Fax:
Practice Address - Street 1:215 N 28TH AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4100
Practice Address - Country:US
Practice Address - Phone:715-847-2866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13847-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily