MEDICARE: WENDY BOCKELMAN NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP145772	TX

General Provider Information

NPI Number	:	1376168831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY BOCKELMAN NP

Provider Business Mailing Address
First Line	:	4666 MCDERMOTT RD STE 100
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-2819
Country	:	US
Telephone Number	:	972-668-6868
Fax Number	:

Provider Business Practice Location Address
First Line	:	4666 MCDERMOTT RD STE 100
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-2819
Country	:	US
Telephone Number	:	972-668-6868
Fax Number	:	972-668-1618

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2020
Last Update Date	:	01/18/2023

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