Individual
MARY WEIGAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5629 COLLEEN LN, WEST BEND, WI 53095-9729
(262) 334-2984
(262) 334-2984
Mailing address
5629 COLLEEN LN, WEST BEND, WI 53095-9729
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
221015-30
WI
Other
Enumeration date
12/16/2015
Last updated
12/16/2015
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