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Individual

KATIE B WIERINGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-5318
(419) 291-6430
Mailing address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-5318
(419) 291-6430

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
4704250648
MI
363LN0005X
Critical Care Neonatal Nurse Practitioner
4704250648
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0057181
OH
Enumeration date
11/08/2011
Last updated
06/23/2015
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