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NPI Code Detail

MEDICARE: WENDY MUMA FNP

MEDICARE: WENDY MUMA FNP
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
1363LF0000XFamily Nurse Practitioner4704194182MI

Other Identifiers

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

General Provider Information

NPI Number : 1720063654
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY MUMA FNP
Provider Business Mailing Address
First Line : 2111 12 MILE RD NW
Second Line :
City : SPARTA
State : MI
Zip : 49345-9754
Country : US
Telephone Number : 616-391-8470
Fax Number : 616-391-8495
Provider Business Practice Location Address
First Line : 2111 12 MILE RD NW
Second Line :
City : SPARTA
State : MI
Zip : 49345-9754
Country : US
Telephone Number : 616-391-8470
Fax Number : 616-391-8495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 02/24/2021

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Directions to “ WENDY MUMA FNP” Practice Location

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