Provider Demographics
NPI:1619087145
Name:WESP, LINDA M (NP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:WESP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4655 N PORT WASHINGTON RD STE 325
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-1000
Mailing Address - Country:US
Mailing Address - Phone:414-999-1099
Mailing Address - Fax:414-999-0699
Practice Address - Street 1:4655 N PORT WASHINGTON RD
Practice Address - Street 2:STE 325
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53212-1000
Practice Address - Country:US
Practice Address - Phone:414-269-8282
Practice Address - Fax:414-269-8280
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6596-33363LF0000X
NY337230363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY337230OtherSTATE LICENSE