Provider Demographics
NPI:1467868844
Name:HALLMARK, WENDY BINDER (NP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:BINDER
Last Name:HALLMARK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61021 DOE RUN DR
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-4795
Mailing Address - Country:US
Mailing Address - Phone:985-974-7370
Mailing Address - Fax:
Practice Address - Street 1:1054 SW RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-3557
Practice Address - Country:US
Practice Address - Phone:855-869-9898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily