Individual
CAITLIN WIEDENHOEFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3305 S 20TH ST STE 100, MILWAUKEE, WI 53215-4940
(414) 645-1984
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3672 - 23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100048644
—
WI
Enumeration date
09/28/2015
Last updated
10/14/2024
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