Provider Demographics
NPI:1902347693
Name:JAUCH, WENDY MARIA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:MARIA
Last Name:JAUCH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 S SILVER SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-6312
Mailing Address - Country:US
Mailing Address - Phone:573-651-3232
Mailing Address - Fax:573-335-0147
Practice Address - Street 1:310 S SILVER SPRINGS RD
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6312
Practice Address - Country:US
Practice Address - Phone:573-651-3232
Practice Address - Fax:573-335-0147
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016040143363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health