Individual
STEPHANIE H WIELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1001 MAIN ST STE 400, PEORIA, IL 61606-2036
(309) 308-0910
(309) 308-0919
Mailing address
1001 MAIN ST STE 400, PEORIA, IL 61606-2036
(309) 308-9010
(309) 308-0919
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-011938
IL
Other
Enumeration date
09/29/2014
Last updated
02/04/2016
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