Provider Demographics
NPI:1174404446
Name:REDFERN, WENDI (RN, ACNS-BC, APNP)
Entity type:Individual
Prefix:
First Name:WENDI
Middle Name:
Last Name:REDFERN
Suffix:
Gender:F
Credentials:RN, ACNS-BC, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W213N16530 GLEN BROOKE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WI
Mailing Address - Zip Code:53037-9367
Mailing Address - Country:US
Mailing Address - Phone:262-707-2616
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1997
Practice Address - Street 2:MS 6804
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53201-1997
Practice Address - Country:US
Practice Address - Phone:414-266-2118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI110852364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics