Healthcare Provider Details

I. General information

NPI: 1174982987
Provider Name (Legal Business Name): WENDY HULME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2016
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 E MAIN STREET RD
BATAVIA NY
14020-3496
US

IV. Provider business mailing address

5130 E MAIN STREET RD
BATAVIA NY
14020-3496
US

V. Phone/Fax

Practice location:
  • Phone: 585-344-1421
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number658885
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: