Individual
MELINDA LOUANN WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, DNP
Contact information
Practice address
2200 NW 26TH ST, OWATONNA, MN 55060-5503
(507) 451-1120
Mailing address
2200 NW 26TH ST, OWATONNA, MN 55060-5503
(507) 451-1120
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5376
MN
363LF0000X
Family Nurse Practitioner
5376
MN
Other
Enumeration date
08/23/2017
Last updated
09/29/2020
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