MEDICARE: WENDY JOSEPH APRN, FNP-BC

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	363LP2300X	Primary Care Nurse Practitioner	APRN11004381	FL
2	363LF0000X	Family Nurse Practitioner	APRN11004381	FL

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

General Provider Information

NPI Number	:	1720627300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY JOSEPH APRN, FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-342-3971
Fax Number	:	239-343-4178

Provider Business Practice Location Address
First Line	:	16281 BASS RD STE 100
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-9687
Country	:	US
Telephone Number	:	239-343-9710
Fax Number	:	239-343-4178

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

Provider Enumeration Date	:	12/31/2019
Last Update Date	:	05/07/2026

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