Individual
MRS. JENNIFER CARTER WIEGAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
5281 CLEVELAND HWY, CLERMONT, GA 30527-2205
(770) 983-4611
(770) 983-9143
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN126531
GA
363LF0000X
Family Nurse Practitioner
RN126531
GA
Other
Enumeration date
12/27/2007
Last updated
01/04/2021
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