Individual
MRS. NICOLE WIEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1200 E MICHIGAN AVE, STE 145, LANSING, MI 48912-1837
(517) 364-5440
(517) 364-5409
Mailing address
1200 E MICHIGAN AVE, STE 145, LANSING, MI 48912-1837
(517) 364-5440
(517) 364-5409
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704242538
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194154476
—
MI
Enumeration date
11/06/2013
Last updated
08/27/2014
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