Individual provider · Type 1 NPI
Jonathan Richard Wiese, AGNP
Primary Care Nurse Practitioner · St. Louis, MO
NPI number
1487130746
Active
Practice location
4921 Parkview Pl, Div Neurology Stroke, Ste 6C
St. Louis, MO 63110-1032
Fax (314) 747-3342
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | 2024008621 (MO) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1487130746
Jonathan Richard Wiese, AGNP's National Provider Identifier is 1487130746, issued on Jul 19, 2018. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in St. Louis, MO. The record was last updated on Apr 17, 2025.