Provider Demographics
NPI:1891066254
Name:GADD, WENDI JO
Entity Type:Individual
Prefix:MRS
First Name:WENDI
Middle Name:JO
Last Name:GADD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 E RIDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1613
Mailing Address - Country:US
Mailing Address - Phone:740-455-4660
Mailing Address - Fax:
Practice Address - Street 1:2775 E RIDGEWOOD CIR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1613
Practice Address - Country:US
Practice Address - Phone:740-455-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.146489164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse