Provider Demographics
NPI:1134959141
Name:LOTEGELUAKI, WENDY (CNM)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:LOTEGELUAKI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:LANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6730
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6730
Mailing Address - Country:US
Mailing Address - Phone:480-821-3600
Mailing Address - Fax:
Practice Address - Street 1:9897 W MCDOWELL RD STE 320
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-1625
Practice Address - Country:US
Practice Address - Phone:480-821-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPENDING367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife