Provider Demographics
NPI:1669559183
Name:DREW, WENDY (APRN)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:
Last Name:DREW
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:DREW
Other - Last Name:MCGANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN, CDC
Mailing Address - Street 1:100 HITCHCOCK WAY
Mailing Address - Street 2:DARTMOUTH HITCHCOCK - ENDOCRINOLOGY
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-4125
Mailing Address - Country:US
Mailing Address - Phone:603-695-2500
Mailing Address - Fax:
Practice Address - Street 1:100 HITCHCOCK WAY
Practice Address - Street 2:DARTMOUTH HITCHCOCK - ENDOCRINOLOGY
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-4125
Practice Address - Country:US
Practice Address - Phone:603-695-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH055561-21163WD0400X
MEAS114003364SA2200X
NH055561-23363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3081008Medicaid
NH3081008Medicaid
ME002523501Medicare PIN