Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 44006 | AZ |
NPI | 1497738314 |
---|---|
Provider Name | Julie A Wendt |
First Address | Scottsdale, AZ 85255-0160 |
Second Address | Scottsdale, AZ 85255-7438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2005 |
Last Update Date | 04/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
668338 | (05) | AZ |