Provider Demographics
NPI:1861916751
Name:REITZ, WENDY M (ARNP-C)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:M
Last Name:REITZ
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39000 BOB HOPE DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-340-2682
Mailing Address - Fax:760-773-9695
Practice Address - Street 1:78120 WILDCAT DR
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-1140
Practice Address - Country:US
Practice Address - Phone:760-340-2682
Practice Address - Fax:760-773-9695
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026822363LF0000X
FL9346992363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily