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Individual

LISA MARIE WEDEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CPNP

Contact information

Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 802-1262
(816) 983-6885
Mailing address
6565 LOWELL DR, MERRIAM, KS 66202-3718
(785) 331-9498
(816) 983-6885

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2013021217
MO
363LP0200X
Pediatric Nurse Practitioner
53-76026-081
KS

Other

Enumeration date
07/03/2013
Last updated
05/22/2015
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