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General NPI Number Information
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NPI Number | 1700021789
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Entity Type | Individual
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Provider Name | WENDY MORTIMER MSN, CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 4201 POTTSVILLE PIKE
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City | READING
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State | PA
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Zip | 19605-1219
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Country | US
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Telephone | 610-921-5811
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Fax |
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Provider Business Mailing Address
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Address Line | 103 CURLEY CT
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City | MOHNTON
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State | PA
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Zip | 19540-8744
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP023203
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP007258
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License Number State | PA
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