Healthcare Provider Details

I. General information

NPI: 1134920135
Provider Name (Legal Business Name): WENDY CHRISTINE THEURER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 POTTERSVILLE RD
CHESTER NJ
07930-2432
US

IV. Provider business mailing address

230 POTTERSVILLE RD
CHESTER NJ
07930-2432
US

V. Phone/Fax

Practice location:
  • Phone: 908-895-4931
  • Fax:
Mailing address:
  • Phone: 908-895-4931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NO09442800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: