Healthcare Provider Details

I. General information

NPI: 1578488672
Provider Name (Legal Business Name): WENDI VENABLE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 N CENTER ST
ELKINS AR
72727-3313
US

IV. Provider business mailing address

349 N CENTER ST
ELKINS AR
72727-3313
US

V. Phone/Fax

Practice location:
  • Phone: 479-387-0618
  • Fax: 479-643-4151
Mailing address:
  • Phone: 479-643-3380
  • Fax: 479-643-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR078178
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: