Individual
MRS. WENDA SUZANNE COLLIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2000 MEDICAL PKWY, STE. 304, ANNAPOLIS, MD 21401-3742
(410) 573-9530
(410) 573-9568
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(410) 573-9530
(410) 573-9568
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R124400
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
239396Y5Z
MEDICARE
MD
01
—
239396ZDWS
MEDICARE
MD
01
—
CY310015
BCBS
MD
Enumeration date
12/02/2006
Last updated
07/21/2022
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