Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 50368 | WI |
NPI | 1003012113 |
---|---|
Provider Name | Wendy Ann Nunes |
First Address | Saint Croix Falls, WI 54024-4117 |
Second Address | Saint Croix Falls, WI 54024-4117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 02/02/2021 |