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NPI Code Detail

MEDICARE: KALLIE WEGNER

MEDICARE: KALLIE WEGNER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther Technician

General Provider Information

NPI Number : 1568394062
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALLIE WEGNER
Provider Business Mailing Address
First Line : 764 W FRANK ST
Second Line :
City : CARO
State : MI
Zip : 48723-1482
Country : US
Telephone Number : 810-667-0500
Fax Number :
Provider Business Practice Location Address
First Line : 1570 SUNCREST DR
Second Line :
City : LAPEER
State : MI
Zip : 48446-1154
Country : US
Telephone Number : 810-667-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ KALLIE WEGNER ” Practice Location

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