Healthcare Provider Details

I. General information

NPI: 1265682033
Provider Name (Legal Business Name): WENDY MICHELE NAGLE NP, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

IV. Provider business mailing address

571 E SALEM AVE
FRESNO CA
93720-2117
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-3000
  • Fax: 559-353-6222
Mailing address:
  • Phone: 559-451-0647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16611
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number2668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: