Provider Demographics
NPI:1285065060
Name:DAMATO, WENDY MICHELE (FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:MICHELE
Last Name:DAMATO
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:MICHELE
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:5008 SR 64 EAST
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208
Mailing Address - Country:US
Mailing Address - Phone:941-896-5845
Mailing Address - Fax:941-896-3082
Practice Address - Street 1:5008 SR 64 EAST
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208
Practice Address - Country:US
Practice Address - Phone:941-896-5845
Practice Address - Fax:941-896-3082
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9175465163WA2000X
FLF1113309363LF0000X
FL2021015855363LP0808X
FLAPRN9175465363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health