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Individual
MRS. SARAH MARIE WENDE
Active
Individual
MRS. SARAH MARIE WENDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00612000
NJ
363A00000X
Physician Assistant
6120
CT
363A00000X
Physician Assistant
MA062387
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1172046
PHYSICIAN ASSISTANT CERTIFICATION BY NCCPA
—
01
—
25MP00612000
STATE LICENSE TO PRACTICE
NJ
01
—
6120
CONNECTICUT STATE LICENSE
CT
01
—
MA062387
STATE LICENSE TO PRACTICE
PA
Enumeration date
04/19/2021
Last updated
09/15/2023
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