Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 634541 | TX |
N | 363LC1500X | Nurse Practitioner - Community Health | RN634541 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 634541 | TX |
NPI | 1720397771 |
---|---|
Provider Name | Debra Lynn Wendel |
First Address | Broaddus, TX 75929-0305 |
Second Address | Broaddus, TX 75929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2010 |
Last Update Date | 04/08/2014 |