Provider Demographics
NPI:1922657063
Name:WHITTINGHAM, WENDY LYNN
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:LYNN
Last Name:WHITTINGHAM
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 1:3308 HANSEN LN
Mailing Address - Street 2:
Mailing Address - City:PHELPS
Mailing Address - State:WI
Mailing Address - Zip Code:54554
Mailing Address - Country:US
Mailing Address - Phone:715-545-2873
Mailing Address - Fax:
Practice Address - Street 1:3308 HANSEN LN
Practice Address - Street 2:
Practice Address - City:PHELPS
Practice Address - State:WI
Practice Address - Zip Code:54554
Practice Address - Country:US
Practice Address - Phone:715-545-2873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider