Individual
NELLA WENNBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
555 WASHINGTON HWY, MORRISVILLE, VT 05661-8972
(802) 888-8405
Mailing address
297 RUBY RAYMOND RD, WATERBURY CENTER, VT 05677-8087
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
055-0030573
VT
Other
Enumeration date
10/13/2006
Last updated
07/23/2012
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