Provider Demographics
NPI:1386056711
Name:THOMAS, WENDY (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 OHLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2331
Mailing Address - Country:US
Mailing Address - Phone:330-941-3489
Mailing Address - Fax:330-884-1500
Practice Address - Street 1:20 OHLTOWN RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2331
Practice Address - Country:US
Practice Address - Phone:330-884-1500
Practice Address - Fax:330-941-3186
Is Sole Proprietor?:No
Enumeration Date:2014-05-20
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH023756363LF0000X
OH2012006272364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily