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NPI Code Detail

MEDICARE: CAROLYN MARIE HEDRINGTON ANP-BC

MEDICARE: CAROLYN MARIE HEDRINGTON ANP-BC
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
1363LF0000XFamily Nurse Practitioner4603-33WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
180805-30OTHERWIRN LIC

General Provider Information

NPI Number : 1386928471
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN MARIE HEDRINGTON ANP-BC
Provider Business Mailing Address
First Line : 5412 US HIGHWAY 10 E
Second Line :
City : STEVENS POINT
State : WI
Zip : 54482-8559
Country : US
Telephone Number : 715-346-5243
Fax Number :
Provider Business Practice Location Address
First Line : 5412 US HIGHWAY 10 E
Second Line :
City : STEVENS POINT
State : WI
Zip : 54482-8559
Country : US
Telephone Number : 715-346-5243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2011
Last Update Date : 12/02/2016

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Directions to “ CAROLYN MARIE HEDRINGTON ANP-BC” Practice Location

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