Individual
GINA M HEDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
939 LALONDE RD, NORTH FORT MYERS, FL 33917-3230
(414) 336-9565
Mailing address
939 LALONDE RD, NORTH FORT MYERS, FL 33917-3230
(414) 336-9565
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN9179912
FL
163WH0200X
Home Health Registered Nurse
33027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103417
RN LICENSE
WI
Enumeration date
12/27/2022
Last updated
12/27/2022
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