Individual
POLLY JOSEPHINE WIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN MSN CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
104967
MO
363LP0200X
Pediatric Nurse Practitioner
44891
KS
Other
Enumeration date
01/22/2007
Last updated
11/18/2015
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