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Individual
WENDY LYNN EASTON
Active
Individual
WENDY LYNN EASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704112593
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10-4827712
—
MI
05
—
10-5198292
—
MI
05
—
10-5198318
—
MI
05
—
11-4976623
—
MI
01
—
11712518
CAQH
—
Enumeration date
08/19/2006
Last updated
11/05/2019
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