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General NPI Number Information
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NPI Number | 1700298395
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Entity Type | Individual
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Provider Name | CARRIE L WIEGERT APRN
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Gender | Female
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Dates
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Enumeration Date | 05/30/2014
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 8445 ANDERMATT DR
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City | LINCOLN
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State | NE
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Zip | 68526-9746
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Country | US
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Telephone | 402-328-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 5327 COOPER AVE
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City | LINCOLN
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State | NE
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Zip | 68506-5014
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Country | US
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Telephone | 402-215-6723
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 70218
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 111664
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License Number State | NE
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