Individual
TIMOTHY R WEDEWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
116249
IA
163W00000X
Registered Nurse
80427-030
WI
2084P0800X
Psychiatry Physician
Primary
G116249
IA
363L00000X
Nurse Practitioner
G116249
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200700010934
ANCC
—
01
—
G116249
IA BOARD NURS
IA
Enumeration date
08/05/2006
Last updated
10/12/2009
Update your record
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