Provider Demographics
NPI:1023533122
Name:DEMLER, WENDY (APN)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:DEMLER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6830 VILLAGREEN VW
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5639
Mailing Address - Country:US
Mailing Address - Phone:815-282-1339
Mailing Address - Fax:815-282-1298
Practice Address - Street 1:6830 VILLAGREEN VW
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5639
Practice Address - Country:US
Practice Address - Phone:815-282-1339
Practice Address - Fax:815-282-1298
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016190363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner