Provider Demographics
NPI:1912033457
Name:AGARWAL, WENDY SUE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:SUE
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:WENDY
Other - Middle Name:SUE
Other - Last Name:AGARWAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:2289 TURNER FALLS ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-1041
Mailing Address - Country:US
Mailing Address - Phone:702-562-0299
Mailing Address - Fax:
Practice Address - Street 1:2289 TURNER FALLS ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-1041
Practice Address - Country:US
Practice Address - Phone:702-562-0299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLPN10515164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse