Provider Demographics
NPI:1295909950
Name:CONNER, WENDY WILKS (CRNP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:WILKS
Last Name:CONNER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 GRANDVIEW PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2027
Mailing Address - Country:US
Mailing Address - Phone:205-250-6805
Mailing Address - Fax:205-250-6580
Practice Address - Street 1:2022 BROOKWOOD MEDICAL CTR DR 510
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6807
Practice Address - Country:US
Practice Address - Phone:205-250-6000
Practice Address - Fax:205-250-6848
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1088021363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALK793Medicare PIN