Healthcare Provider Details

I. General information

NPI: 1861336976
Provider Name (Legal Business Name): WENDY WALDECK MCLAUGHLIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43220 DARKWOODS ST
CHANTILLY VA
20152-4430
US

IV. Provider business mailing address

43220 DARKWOODS ST
CHANTILLY VA
20152-4430
US

V. Phone/Fax

Practice location:
  • Phone: 757-739-2424
  • Fax:
Mailing address:
  • Phone: 757-739-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024197099
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: