Individual
ELIZABETH G WIEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1200 E MARSHALL ST, RICHMOND, VA 23298-5023
(804) 828-4104
(804) 828-0856
Mailing address
PO BOX 780125, PHILADELPHIA, PA 19178-0125
(804) 922-4844
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024184262
VA
363LF0000X
Family Nurse Practitioner
53-80454-012
KS
363LP2300X
Primary Care Nurse Practitioner
2021002517
MO
Other
Enumeration date
09/08/2021
Last updated
08/25/2025
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