Individual
GLENDA WEIGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
835 S MAIN ST, STE 1, OCONTO FALLS, WI 54154-1282
(920) 846-8187
(920) 846-2073
Mailing address
855 S MAIN ST, OCONTO FALLS, WI 54154-1241
(920) 846-3444
(920) 846-0250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
137624-30
WI
363L00000X
Nurse Practitioner
Primary
5671-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014110
—
WI
01
—
1851477913
CMH NPI
WA
Enumeration date
02/05/2014
Last updated
05/09/2016
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