Provider Demographics
NPI:1548325327
Name:BECKER, WENDY M (RN)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:M
Last Name:BECKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 ISLAND VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:HUSTISFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53034-9706
Mailing Address - Country:US
Mailing Address - Phone:262-224-6277
Mailing Address - Fax:
Practice Address - Street 1:201 N WATER ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53094-7683
Practice Address - Country:US
Practice Address - Phone:262-224-6277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health