Provider Demographics
NPI:1831698562
Name:LEDLOW, WENDY LANGLEY (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LANGLEY
Last Name:LEDLOW
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MEDICAL PARK
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-1804
Mailing Address - Country:US
Mailing Address - Phone:251-928-8804
Mailing Address - Fax:251-990-9379
Practice Address - Street 1:3 MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1804
Practice Address - Country:US
Practice Address - Phone:251-928-8804
Practice Address - Fax:251-990-9379
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-109299363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner