Healthcare Provider Details

I. General information

NPI: 1255336681
Provider Name (Legal Business Name): GLENDA KAY WENDLING FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 04/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 N MILFORD DR
FRANKLIN IN
46131-7308
US

IV. Provider business mailing address

55 N MILFORD DR
FRANKLIN IN
46131-7308
US

V. Phone/Fax

Practice location:
  • Phone: 317-739-4848
  • Fax: 317-346-4062
Mailing address:
  • Phone: 317-739-4848
  • Fax: 317-346-4062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71000057A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: