Healthcare Provider Details

I. General information

NPI: 1659275469
Provider Name (Legal Business Name): WENDY HOPE MIDDLETON PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 BIG DIPPER
CLOUDCROFT NM
88317-9458
US

IV. Provider business mailing address

201 BIG DIPPER
CLOUDCROFT NM
88317-9458
US

V. Phone/Fax

Practice location:
  • Phone: 253-370-0030
  • Fax:
Mailing address:
  • Phone: 253-370-0030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number92227
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: