Basic Information
| Provider Information | |||||||||
| NPI: | 1306108477 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PYLE | ||||||||
| FirstName: | WENDY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 313 WOODLAKE DR | ||||||||
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| City: | BRANDON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390476091 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019518939 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 E UNION ST | ||||||||
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| City: | GREENVILLE | ||||||||
| State: | MS | ||||||||
| PostalCode: | 387033246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6623783783 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2012 | ||||||||
| LastUpdateDate: | 06/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | R867456 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.