Individual
JESSICA L WIEDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
329 W 40TH ST, SCOTTSBLUFF, NE 69361-4634
(308) 635-3911
(308) 635-3130
Mailing address
329 W 40TH ST, SCOTTSBLUFF, NE 69361-4634
(308) 635-3911
(308) 635-3130
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101161
NE
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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