Wiedmeyer, Michael James

Wiedmeyer, Michael James is an individual health care provider with primary practice located at 820 Decker Dr , West Bend WI 53090-2341. He recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as his primary health care specialty. Wiedmeyer, Michael James can be contacted via phone (262) 306-9815.

Contact Information

Primary practice address
820 Decker Dr West Bend WI 53090-2341
Phone: (262) 306-9815
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 33507-031 Wisconsin

Profile Details

NPI number 1013975150
LBN Legal business name Wiedmeyer, Michael James
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013975150 NPPES
Wisconsin MEDICAID 38335700

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