Individual
JENNY MARIE WEIGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Taxonomy
Speciality
Code
Description
License number
State
163WF0300X
Flight Registered Nurse
30357
MT
363LN0000X
Neonatal Nurse Practitioner
Primary
NUR-APRN-LIC-194283
MT
Other
Enumeration date
11/21/2011
Last updated
04/10/2025
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