Individual
MRS. BETH A WEIDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
818 FOREST LN, WATERFORD, WI 53185-4585
(262) 514-3700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 514-3700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4246
WI
363LF0000X
Family Nurse Practitioner
209008975
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100026355
—
WI
Enumeration date
11/11/2010
Last updated
10/18/2023
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