Provider Demographics
NPI:1427449313
Name:CROTTS, WENDY DENAE (APRN)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:DENAE
Last Name:CROTTS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MOORELAND
Mailing Address - State:OK
Mailing Address - Zip Code:73852-7602
Mailing Address - Country:US
Mailing Address - Phone:580-994-2188
Mailing Address - Fax:580-254-8658
Practice Address - Street 1:417 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:MOORELAND
Practice Address - State:OK
Practice Address - Zip Code:73852-7602
Practice Address - Country:US
Practice Address - Phone:580-994-2188
Practice Address - Fax:580-254-8658
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK92458363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily