Individual
MS. CARLI J WIERSEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9330 BROADWAY, CROWN POINT, IN 46307-8602
(219) 662-5000
Mailing address
1326 LANTZ LN, SCHERERVILLE, IN 46375-3028
(219) 864-4350
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001182A
IN
Other
Enumeration date
03/14/2006
Last updated
07/08/2007
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