Individual
KAYCEE R. WIELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1313 W FERGUSON AVE, BLACKWELL, OK 74631-5604
(580) 789-3100
Mailing address
803 S 12TH ST, BLACKWELL, OK 74631-5614
(405) 831-9794
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0097343
OK
Other
Enumeration date
10/13/2021
Last updated
11/11/2021
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