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Individual

MRS. TRACI WIEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(720) 536-7552
Mailing address
200 LEONARD LN, NORTHGLENN, CO 80233-3331
(303) 280-1517

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
196681
CO

Other

Enumeration date
10/27/2010
Last updated
10/27/2010
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