Provider Demographics
NPI:1093536203
Name:WENNBERG, ERIN KELLEY (RN)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:KELLEY
Last Name:WENNBERG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:KELLEY
Other - Last Name:SPENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-1122
Mailing Address - Country:US
Mailing Address - Phone:443-280-8713
Mailing Address - Fax:
Practice Address - Street 1:500 E STEIN HWY
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-1530
Practice Address - Country:US
Practice Address - Phone:302-629-4586
Practice Address - Fax:302-628-4485
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0038536163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool