Individual
MS. NANCY L WIEDEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
Mailing address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP003334C
PA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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