Provider Demographics
NPI:1033728100
Name:WENDOLOWSKI, KAITLYN (CRNP)
Entity type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:
Last Name:WENDOLOWSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12205 COUNTY LINE RD STE B
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-7720
Mailing Address - Country:US
Mailing Address - Phone:256-325-6722
Mailing Address - Fax:256-325-6724
Practice Address - Street 1:12205 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-7719
Practice Address - Country:US
Practice Address - Phone:256-325-6722
Practice Address - Fax:256-517-8082
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-175016363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner