Individual
MRS. MARY LOUISE MCWETHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
5200 HAHNS PEAK DR, LOVELAND, CO 80538-8852
(307) 920-2997
Mailing address
1115 WHITE ROCK DR, DIXON, IL 61021-9050
(815) 440-7901
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.406026
IL
363L00000X
Nurse Practitioner
APN.0999064-NP
CO
363LF0000X
Family Nurse Practitioner
Primary
209023913
IL
363LF0000X
Family Nurse Practitioner
APN.0999064-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209023913
APRN LICENSE NUMBER
IL
Enumeration date
12/01/2021
Last updated
09/19/2023
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