MEDICARE: WENDY MICHELLE LAMB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1619605268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY MICHELLE LAMB

Provider Business Mailing Address
First Line	:	PO BOX 57
Second Line	:
City	:	JASPER
State	:	AR
Zip	:	72641-0057
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 ROCK SPRINGS RD
Second Line	:
City	:	HARRISON
State	:	AR
Zip	:	72601-8804
Country	:	US
Telephone Number	:	870-446-2757
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2022
Last Update Date	:	01/31/2024

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