Lorie Rose Wendt, Pllc

NPI #1790568467 in Rockford, Illinois

Provider Information

NPI Number: 1790568467
Entity Type: Organization
Organization Name: Lorie Rose Wendt, Pllc
Primary Specialty: Nurse Practitioner
Enumeration Date: Aug 16, 2023
Last Updated: Aug 16, 2023

Practice Location

Address: 2323 SANDHUTTON AVE
City: Rockford
State: Illinois
ZIP Code: 61108-8087
Phone: (815) 566-2052

Authorized Official

Name: LESLIE ELMER, CPCS
Title: CREDENTIALING
Phone: (608) 352-8323

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X	Primary

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