Healthcare Provider Details

I. General information

NPI: 1033673132
Provider Name (Legal Business Name): WENDY RENEE PERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

469 MIGEON AVE
TORRINGTON CT
06790-4643
US

IV. Provider business mailing address

5741 BEE RIDGE RD
SARASOTA FL
34233-5064
US

V. Phone/Fax

Practice location:
  • Phone: 860-489-0931
  • Fax:
Mailing address:
  • Phone: 941-926-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number9368742
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF343787-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number9368742
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: