Individual
AMI NICOLE WIETZIKOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
161 PRIVATE ROAD 5706A, KOSSE, TX 76653-3937
(903) 390-1339
Mailing address
161 PRIVATE ROAD 5706A, KOSSE, TX 76653-3937
(903) 390-1339
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
886451
TX
Other
Enumeration date
06/11/2026
Last updated
06/11/2026
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