Individual
WENDY WAMBAUGH VANVALKENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
21812 WOODLAND RD, HOUGHTON, MI 49931-9003
(906) 523-2448
Mailing address
21812 WOODLAND RD, HOUGHTON, MI 49931-9003
(906) 523-2448
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
569856-1
NY
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NPI#1518161058
MESSA, BLUE CROSS BLUE SHIELD OF MICHIGNA
MI
05
—
NPI#1518161058
—
MI
Enumeration date
06/11/2007
Last updated
01/31/2013
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