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1093256950
JESSICA A. WIEDEMANN
FORT WAYNE, IN
NPI
1093256950
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IN 71006951A)
Enumeration Date
2017-03-13
Last Update Date
2017-09-18
Business Address
-- JESSICA A. WIEDEMANN NP
7601 W JEFFERSON BLVD
FORT WAYNE, IN 46804-4133
Phone number: 260-436-8686
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Mailing Address
-- JESSICA A. WIEDEMANN NP
3926 NEW VISION DR
FORT WAYNE, IN 46845-1712
Phone number: 260-436-8686
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