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General NPI Number Information
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NPI Number | 1891899209
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Entity Type | Individual
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Provider Name | JULIA WIEGERS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1418 CROSS ST STE 250
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City | SHILOH
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State | IL
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Zip | 62269-2965
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Country | US
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Telephone | 618-236-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1116 HARTMAN LN
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City | SHILOH
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State | IL
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Zip | 62221-8014
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Country | US
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Telephone | 618-641-9011
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2003021315
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2770022022
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.006539
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License Number State | IL
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