Healthcare Provider Details

I. General information

NPI: 1750356895
Provider Name (Legal Business Name): ANNE MARIE WENDT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41601 N DEER TRAIL RD
CAVE CREEK AZ
85331-2848
US

IV. Provider business mailing address

1842 S ASH
MESA AZ
85202-5863
US

V. Phone/Fax

Practice location:
  • Phone: 602-575-0576
  • Fax:
Mailing address:
  • Phone: 480-752-3779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN 051789
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: