Healthcare Provider Details

I. General information

NPI: 1184715518
Provider Name (Legal Business Name): WENDY JO HAMLIN RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 ARMSTRONG RD BLDG 84 ROOM 007
BATTLE CREEK MI
49015-1014
US

IV. Provider business mailing address

3116 FULFORD ST
KALAMAZOO MI
49001-4490
US

V. Phone/Fax

Practice location:
  • Phone: 269-966-5600
  • Fax: 269-660-3096
Mailing address:
  • Phone: 269-966-5600
  • Fax: 269-660-3096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number4704109239
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: