Provider Demographics
NPI:1659113660
Name:GUYETTE, WENDY LIN (APNP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LIN
Last Name:GUYETTE
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:LIN
Other - Last Name:KONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N4514 OSTRANDER RD
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:WI
Mailing Address - Zip Code:54961-8032
Mailing Address - Country:US
Mailing Address - Phone:920-538-4166
Mailing Address - Fax:
Practice Address - Street 1:1405 MILL ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:WI
Practice Address - Zip Code:54961-2155
Practice Address - Country:US
Practice Address - Phone:920-531-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15355-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily