Provider Demographics
NPI:1043300759
Name:ALLENBY, WENDY SUE (PAC)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:SUE
Last Name:ALLENBY
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:SUE
Other - Last Name:ULLOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:118 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-7004
Mailing Address - Country:US
Mailing Address - Phone:304-780-9860
Mailing Address - Fax:304-242-4840
Practice Address - Street 1:30 MEDICAL PARK
Practice Address - Street 2:SUITE 233
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6391
Practice Address - Country:US
Practice Address - Phone:304-242-9560
Practice Address - Fax:304-242-4840
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV01235363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant