Healthcare Provider Details

I. General information

NPI: 1679327167
Provider Name (Legal Business Name): WENDY ANN YOUNG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2024
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 COUNTY ROAD 44A
WILDWOOD FL
34785-8655
US

IV. Provider business mailing address

1540 COUNTY ROAD 44A
WILDWOOD FL
34785-8655
US

V. Phone/Fax

Practice location:
  • Phone: 352-535-8110
  • Fax: 352-535-8111
Mailing address:
  • Phone: 352-535-8110
  • Fax: 352-535-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11032281
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: