Provider Demographics
NPI:1710467519
Name:WEGSCHEID, KIMBERLY ANNE (FNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANNE
Last Name:WEGSCHEID
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S CHAPMAN ST
Mailing Address - Street 2:
Mailing Address - City:CHESANING
Mailing Address - State:MI
Mailing Address - Zip Code:48616-1304
Mailing Address - Country:US
Mailing Address - Phone:989-845-7644
Mailing Address - Fax:989-845-4710
Practice Address - Street 1:300 S CHAPMAN ST
Practice Address - Street 2:
Practice Address - City:CHESANING
Practice Address - State:MI
Practice Address - Zip Code:48616-1304
Practice Address - Country:US
Practice Address - Phone:989-845-7644
Practice Address - Fax:989-845-4710
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704314108363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily