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General NPI Number Information
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NPI Number | 1295969137
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Entity Type | Individual
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Provider Name | CAROL ANN WEDDLE ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 2210 DUNCAN REGIONAL LOOP
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City | DUNCAN
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State | OK
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Zip | 73533-1564
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Country | US
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Telephone | 580-251-6657
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 W PINE AVE
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City | DUNCAN
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State | OK
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Zip | 73533-4257
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Country | US
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Telephone | 405-234-0065
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R29458
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License Number State | OK
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