Individual
LEAH ANN WIETING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-9646
Mailing address
2912 WALSH LOOP SE, RIO RANCHO, NM 87124-2982
(505) 688-0847
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-03558
NM
Other
Enumeration date
08/19/2019
Last updated
10/02/2019
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