Individual
OLENA V WIEDEMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
2741 ROOSEVELT RD, MARINETTE, WI 54143-3833
(715) 732-1392
Mailing address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704317913
MI
363LF0000X
Family Nurse Practitioner
Primary
7853-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20117009758
ANCC
—
01
—
7853-33
WISCONSIN DSPS BOARD OF NURSING
WI
Enumeration date
08/10/2017
Last updated
06/06/2018
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