Individual
MRS. LORA WIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2201 N BROADWELL AVE, GRAND ISLAND, NE 68803-2153
(308) 382-3660
Mailing address
2201 N BROADWELL AVE, GRAND ISLAND, NE 68803-2153
(308) 382-3660
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
114201
NE
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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