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General NPI Number Information
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NPI Number | 1013226497
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Entity Type | Individual
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Provider Name | THERESA LYNN WENDT APNP
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Gender | Female
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Dates
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Enumeration Date | 10/01/2010
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 8136 S MISSION DR
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City | FRANKLIN
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State | WI
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Zip | 53132-2353
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Country | US
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Telephone | 414-861-4875
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Fax | 414-427-9711
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Provider Business Mailing Address
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Address Line | 6001W NORTH AVE
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City | MILWAUKEE
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State | WI
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Zip | 53213-1527
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Country | US
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Telephone | 414-771-6315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3968-033
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License Number State | WI
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