Individual provider · Type 1 NPI

Kelly Wiedower

Family Nurse Practitioner · Greensboro, GA

NPI number 1629528450 Active

Practice location

1041 Park Dr
Greensboro, GA 30642-3465

Call (706) 453-4945 Map

Mailing address

1081 Princeton Ln
Watkinsville, GA 30677-5338

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X213342 (GA)

Family Nurse Practitioner: Definition to come...

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About NPI 1629528450

Kelly Wiedower's National Provider Identifier is 1629528450, issued on Oct 5, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Greensboro, GA. The record was last updated on Oct 5, 2016.