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Individual

MRS. MARY LOUISE WIELICZKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, FNP-BC

Contact information

Practice address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160-0001
(913) 588-6029
Mailing address
8604 W 72ND TER, OVERLAND PARK, KS 66204-1752
(913) 236-5703

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
079101
MO
363LF0000X
Family Nurse Practitioner
Primary
46296
KS

Other

Enumeration date
10/28/2008
Last updated
03/09/2009
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