Individual
WYCONDA ELAINE WEDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 HARRISON PLZ, FLORENCE, AL 35632-0002
(256) 765-4984
Mailing address
814 BASCOM RD, JACKSON, TN 38305-9698
(731) 225-8558
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0000220121
TN
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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