Provider Demographics
NPI:1649251455
Name:GILCHRIST, WENDI CUNNINGHAM (NP)
Entity type:Individual
Prefix:MRS
First Name:WENDI
Middle Name:CUNNINGHAM
Last Name:GILCHRIST
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:WENDI
Other - Middle Name:ANN
Other - Last Name:CUNNINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4348 EXULTANT DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-6045
Mailing Address - Country:US
Mailing Address - Phone:310-750-6827
Mailing Address - Fax:
Practice Address - Street 1:1124 W CARSON ST
Practice Address - Street 2:N-28
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2006
Practice Address - Country:US
Practice Address - Phone:310-222-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN534567163W00000X
CANP11404363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse