Healthcare Provider Details

I. General information

NPI: 1811383433
Provider Name (Legal Business Name): WENDY SUE LEROY ARNP-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE HOSPITAL AVE
STUART FL
34994-2346
US

IV. Provider business mailing address

10373 SW LIGUSTRUM DR
PORT SAINT LUCIE FL
34987-2875
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-5600
  • Fax:
Mailing address:
  • Phone: 772-209-9865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberARNP9288118
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN9288118
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9288118
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: