Healthcare Provider Details

I. General information

NPI: 1235924200
Provider Name (Legal Business Name): WENDI LENTZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 N DELAWARE DR LOT 88
APACHE JUNCTION AZ
85120-1851
US

IV. Provider business mailing address

1615 N DELAWARE DR LOT 88
APACHE JUNCTION AZ
85120-1851
US

V. Phone/Fax

Practice location:
  • Phone: 815-908-3022
  • Fax: 815-908-3022
Mailing address:
  • Phone: 815-908-3022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number321902
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: