Provider Demographics
NPI:1750617635
Name:SPRY, WENDY LYNNE (LVN)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LYNNE
Last Name:SPRY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26725 MANZANARES
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5927
Mailing Address - Country:US
Mailing Address - Phone:949-233-1360
Mailing Address - Fax:
Practice Address - Street 1:26725 MANZANARES
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5927
Practice Address - Country:US
Practice Address - Phone:949-233-1360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 232280374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula