Provider Demographics
NPI:1124873435
Name:KAUFFMAN, WENDY ANN
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:ANN
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4136 VAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-6107
Mailing Address - Country:US
Mailing Address - Phone:573-823-8324
Mailing Address - Fax:
Practice Address - Street 1:101 DILLON CT
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:TN
Practice Address - Zip Code:37615-3555
Practice Address - Country:US
Practice Address - Phone:423-477-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist