Individual
MS. NANCY ANNE WICHTENDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
UMC STONY BRK, HSC T-16-080, STONY BROOK, NY 11794-0001
(631) 444-3575
(631) 444-1054
Mailing address
UMC STONY BRK, HSC T-16-080, STONY BROOK, NY 11794-0001
(631) 444-3575
(631) 444-1054
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
F301619
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F301619
NY
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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