Provider Demographics
NPI:1720627300
Name:JOSEPH, WENDY (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5558 LAKE HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1036
Mailing Address - Country:US
Mailing Address - Phone:407-635-5730
Mailing Address - Fax:407-635-5731
Practice Address - Street 1:5558 LAKE HOWELL RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1036
Practice Address - Country:US
Practice Address - Phone:407-635-5730
Practice Address - Fax:407-635-5731
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004381207Q00000X
FLAPRN11004381363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine