Provider Demographics
NPI:1346081924
Name:FLANAGAN, WENDI (RN)
Entity type:Individual
Prefix:MS
First Name:WENDI
Middle Name:
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 25TH AVE S APT A
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-3163
Mailing Address - Country:US
Mailing Address - Phone:727-831-3241
Mailing Address - Fax:
Practice Address - Street 1:677 25TH AVE S APT A
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-3163
Practice Address - Country:US
Practice Address - Phone:727-831-3241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9525593163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse