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General NPI Number Information
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NPI Number | 1891079950
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Entity Type | Individual
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Provider Name | WENDY S MEDFORD RN
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Gender | Female
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 9261 W VAN BUREN ST
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City | TOLLESON
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State | AZ
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Zip | 85353-2941
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Country | US
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Telephone | 623-936-9740
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Fax | 623-936-9757
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Provider Business Mailing Address
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Address Line | 6162 S 258TH DR
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City | BUCKEYE
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State | AZ
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Zip | 85326-2150
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Country | US
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Telephone | 801-694-0645
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | RN115980
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License Number State | AZ
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