Provider Demographics
NPI:1912021767
Name:WENDT, CARY KATHRYN (CPNP)
Entity Type:Individual
Prefix:
First Name:CARY
Middle Name:KATHRYN
Last Name:WENDT
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 LANIER AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5321
Mailing Address - Country:US
Mailing Address - Phone:410-601-9300
Mailing Address - Fax:410-601-9499
Practice Address - Street 1:5101 LANIER AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5321
Practice Address - Country:US
Practice Address - Phone:410-601-9300
Practice Address - Fax:410-601-9300
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR118633363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics