Individual
MRS. SANDRA ANN WEILAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
102 NORTH CHOCTAW, WAPANUCKA, OK 73461
(580) 428-3527
Mailing address
102 NORTH CHOCTAW STREET, WAPANUCKA, OK 73461
(580) 937-9900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0060869
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200046190A
—
OK
Enumeration date
12/11/2007
Last updated
12/11/2007
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