Individual
MISS REBECCA ANNE WIEDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2009 BROWN ST STE 7, ANDERSON, IN 46016-4222
(765) 649-1251
(765) 649-1710
Mailing address
2009 BROWN ST STE 7, ANDERSON, IN 46016-4222
(765) 649-1251
(765) 649-1710
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26019355A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26019355A
STATE LICENSE NUMBER
IN
Enumeration date
06/14/2020
Last updated
06/14/2020
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