Individual
KORI WREN WIEGMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1515 NW LAWRIE TATUM ROAD, LAWTON, OK 73507
(580) 354-5000
Mailing address
1515 NW LAWRIE TATUM ROAD, LAWTON, OK 73507
(580) 358-5000
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
R0122653
OK
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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