Provider Demographics
NPI:1740698315
Name:BOSLEY, WENDY KAY (CRNP)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:KAY
Last Name:BOSLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:KAY
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-4017
Mailing Address - Country:US
Mailing Address - Phone:410-414-9116
Mailing Address - Fax:
Practice Address - Street 1:130 HOSPITAL RD STE 201
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4055
Practice Address - Country:US
Practice Address - Phone:410-414-4700
Practice Address - Fax:410-286-7907
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR130333363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner