Individual
NATHAN S WENDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1072 S DIXIE BLVD, RADCLIFF, KY 40160-1103
(270) 765-2605
(270) 234-8572
Mailing address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
(270) 234-8572
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2007-08
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000548926
ANTHEM
KY
05
—
30605018
—
KY
Enumeration date
02/19/2007
Last updated
03/27/2008
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