Provider Demographics
NPI:1871725473
Name:HASTINGS, WENDY LOUISE (RN)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LOUISE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4328 PAGE AVE
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49254-1036
Mailing Address - Country:US
Mailing Address - Phone:517-764-3609
Mailing Address - Fax:517-764-3659
Practice Address - Street 1:4328 PAGE AVE
Practice Address - Street 2:
Practice Address - City:MICHIGAN CENTER
Practice Address - State:MI
Practice Address - Zip Code:49254-1036
Practice Address - Country:US
Practice Address - Phone:517-764-3609
Practice Address - Fax:517-764-3659
Is Sole Proprietor?:No
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704224290163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management