Individual
ANYA WIEDENBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
455 FOREST PKWY, FOREST PARK, GA 30297-2126
(678) 705-0100
Mailing address
4502 WOODHALL WAY NE, ROSWELL, GA 30075-1997
(678) 879-8581
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN260056
GA
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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