Fennelly, Wendy C.

Fennelly, Wendy C. is an individual health care provider with primary practice located at 345 Blackstone Blvd , Providence RI 02906-4800. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Fennelly, Wendy C. can be contacted via phone (401) 455-6200.

Contact Information

Primary practice address
345 Blackstone Blvd Providence RI 02906-4800
Phone: (401) 455-6200
Fax: (401) 455-6404
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 64 Rhode Island
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 64 Rhode Island

Profile Details

NPI number 1336347491
LBN Legal business name Fennelly, Wendy C.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2007
Last updated Jun 13th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336347491 NPPES
Rhode Island Other 33164-7 BCBS
Rhode Island Other 414051 BCBS
Rhode Island MEDICAID WF68506 BCBS

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