Healthcare Provider Details

I. General information

NPI: 1255304184
Provider Name (Legal Business Name): WENDY LEA MARKOVICH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WENDY LEA LONGCHAMPS NP

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S MILL AVE
TEMPE AZ
85281-2889
US

IV. Provider business mailing address

8414 E. SHEA BOULEVARD SUITE 103
SCOTTSDALE AZ
85260
US

V. Phone/Fax

Practice location:
  • Phone: 602-345-0647
  • Fax:
Mailing address:
  • Phone: 480-917-7800
  • Fax: 480-917-8500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAZ2787
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number003315
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP2787
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN146859
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number072310
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: