Individual
MRS. MARCELLA WILDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-BC
Contact information
Practice address
916 JACKSON AVE # A, SHERIDAN, WY 82801-2708
(130) 767-5555
Mailing address
916 JACKSON AVE # A, SHERIDAN, WY 82801-2708
(307) 675-5555
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP60701532
WA
363LP2300X
Primary Care Nurse Practitioner
Primary
48029
WY
Other
Enumeration date
10/14/2016
Last updated
05/13/2024
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