Individual
MRS. SANDRA KELLEY WIELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-PMH
Contact information
Practice address
813 CHESAPEAKE DR STE 1, CAMBRIDGE, MD 21613-9405
(410) 221-2266
(410) 221-2878
Mailing address
813 CHESAPEAKE DR STE 1, CAMBRIDGE, MD 21613-9405
(410) 221-2266
(410) 221-2878
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RO38366
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R038366
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415081300
—
MD
05
—
479302100
—
MD
Enumeration date
07/18/2007
Last updated
05/13/2019
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