MEDICARE: MRS. AMY SUSAN WENDEL FNP-C

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	NP-09255	OH
2	363LF0000X	Family Nurse Practitioner	15665	WI
3	363LF0000X	Family Nurse Practitioner	95035445	CA

General Provider Information

NPI Number	:	1982894390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY SUSAN WENDEL FNP-C

Provider Business Mailing Address
First Line	:	21 E STATE ST OFC 233
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-4281
Country	:	US
Telephone Number	:	419-953-3021
Fax Number	:	419-375-5560

Provider Business Practice Location Address
First Line	:	302 W WIGGS ST
Second Line	:
City	:	FT RECOVERY
State	:	OH
Zip	:	45846
Country	:	US
Telephone Number	:	419-375-5550
Fax Number	:	419-375-5560

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

Provider Enumeration Date	:	07/31/2007
Last Update Date	:	01/15/2026

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