Individual
ANGELA R VANDEWETTERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1111 BAYSHORE DR, MANITOWOC, WI 54220-5548
(920) 682-6376
Mailing address
PO BOX 28900, GREEN BAY, WI 54324-0900
(920) 490-9046
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14063
WI
363LF0000X
Family Nurse Practitioner
14063-33
WI
Other
Enumeration date
06/12/2023
Last updated
07/27/2023
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