Provider Demographics
NPI:1649597311
Name:WEDEMEYER, ERIN (RN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:WEDEMEYER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 SPARTA RD
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1424
Mailing Address - Country:US
Mailing Address - Phone:254-231-0083
Mailing Address - Fax:254-939-5454
Practice Address - Street 1:255 SPARTA RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1424
Practice Address - Country:US
Practice Address - Phone:254-231-0083
Practice Address - Fax:254-939-5454
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator