Provider Demographics
NPI:1952927824
Name:LINK, WENDELL RAYMOND JR (RN)
Entity Type:Individual
Prefix:MR
First Name:WENDELL
Middle Name:RAYMOND
Last Name:LINK
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 WECKERLY RD
Mailing Address - Street 2:
Mailing Address - City:MONCLOVA
Mailing Address - State:OH
Mailing Address - Zip Code:43542-9498
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4140 WECKERLY RD
Practice Address - Street 2:
Practice Address - City:MONCLOVA
Practice Address - State:OH
Practice Address - Zip Code:43542-9498
Practice Address - Country:US
Practice Address - Phone:567-288-4406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH394090163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine