Provider Demographics
NPI:1538322565
Name:WENZELBURGER, DONNA (RNC, WHNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:WENZELBURGER
Suffix:
Gender:F
Credentials:RNC, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3844 S LINDBERGH BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1368
Mailing Address - Country:US
Mailing Address - Phone:314-842-0240
Mailing Address - Fax:
Practice Address - Street 1:3844 S LINDBERGH BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1368
Practice Address - Country:US
Practice Address - Phone:314-842-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO091029363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology