Individual
TANYA LYNN WEIDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP
Contact information
Practice address
1752 DORSET LN, NEW RICHMOND, WI 54017-2452
(715) 307-7553
Mailing address
1038 TOWN HALL RD, RIVER FALLS, WI 54022-5803
(715) 307-7553
(715) 425-0438
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2108214
MN
163WH0200X
Home Health Registered Nurse
0193509
WI
2084P0800X
Psychiatry Physician
1509033
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
11485
MN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1509033
WI
Other
Enumeration date
12/07/2018
Last updated
03/04/2025
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