TINA L VIDETIC

SHEBOYGAN, WI
NPI1396930707
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: WI  3260)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: WI  3260)
Enumeration Date2007-09-09
Last Update Date2023-12-15
Business Address
TINA L VIDETIC APRN, BC
2414 KOHLER MEMORIAL DR
SHEBOYGAN, WI 53081-3129
Phone number: 920-457-4461
Mailing Address
TINA L VIDETIC APRN, BC
PO BOX 735044
CHICAGO, IL 60673-5044
Phone number: 800-326-2250