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Kelly Wiedower
Family Nurse Practitioner in Greensboro, Georgia
NPI 1629528450

Kelly Wiedower is a Family Nurse Practitioner based in Watkinsville, GA and is specialized in Family. Kelly Wiedower practices in Greensboro, GA. The NPI Number for Kelly Wiedower is 1629528450 and holds a License No. 213342 (Georgia).

The current practice location address for Kelly Wiedower is 1041 Park Dr, Greensboro, GA and can be reached out via phone at 706-453-4945.

Location: 1041 Park Dr, Greensboro, GA, 30677-5338
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629528450
Provider Name
Kelly Wiedower
Credential
Provider Entity Type
Individual
Gender
Female
Address
1041 Park Dr, Greensboro, GA, 30677-5338
Phone Number
706-453-4945
Fax Number
Provider Enumeration Date
10/05/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1041 Park Dr
City
Greensboro
State
Georgia
Zip
30642-3465
Phone Number
706-453-4945
Fax Number
person
Provider Business Mailing Address Details
Address
1041 Park Dr
City
Greensboro
State
Georgia
Zip
30642-3465
Phone Number
706-453-4945
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
213342 (Georgia)
Definition
Definition to come...
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