Individual
WENDY MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
802 MEDICAL DR STE 202, LONGVIEW, TX 75605-5203
(903) 315-2744
(903) 234-1339
Mailing address
802 MEDICAL DR STE 202, LONGVIEW, TX 75605-5203
(903) 315-2744
(903) 234-1339
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP121666
TX
363LW0102X
Women's Health Nurse Practitioner
648633
TX
363LW0102X
Women's Health Nurse Practitioner
Primary
AP121666
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303491003
—
TX
Enumeration date
03/27/2012
Last updated
07/12/2024
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