Individual
ADDISON TAYLOR WEGLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3056
(208) 882-4511
Mailing address
929 MABELLE ST, MOSCOW, ID 83843-3833
(605) 645-9336
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R057144
SD
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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