Provider Demographics
NPI:1891120762
Name:BORGERSEN, WENDY LYNN (CPNP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LYNN
Last Name:BORGERSEN
Suffix:
Gender:
Credentials:CPNP
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:LYNN
Other - Last Name:OJEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2108 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7761
Mailing Address - Country:US
Mailing Address - Phone:602-933-3124
Mailing Address - Fax:
Practice Address - Street 1:1919 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7710
Practice Address - Country:US
Practice Address - Phone:602-933-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5163363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ577794Medicaid
AZ1609879964OtherNPI (ELAINE SANTOS, MD)
1760594543OtherNPI (DAVID S. YIP, MD)
AZ532459Medicaid