MEDICARE: WENDY L DUSENBURY ARNP

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	21046	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447255526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY L DUSENBURY ARNP

Provider Business Mailing Address
First Line	:	1325 EASTMORELAND AVE
Second Line	:	SUITE 220
City	:	MEMPHIS
State	:	TN
Zip	:	38104-3519
Country	:	US
Telephone Number	:	901-448-5227
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 EASTMORELAND AVE
Second Line	:	SUITE 220
City	:	MEMPHIS
State	:	TN
Zip	:	38104-3519
Country	:	US
Telephone Number	:	901-448-5227
Fax Number	:

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	05/01/2025

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