Provider Demographics
NPI:1992087571
Name:SIRKO, WENDY LEE (RN)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LEE
Last Name:SIRKO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 MILL ST
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2818
Mailing Address - Country:US
Mailing Address - Phone:810-720-6900
Mailing Address - Fax:810-720-6905
Practice Address - Street 1:420 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2445
Practice Address - Country:US
Practice Address - Phone:810-257-3724
Practice Address - Fax:810-257-3733
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704281541163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse