Carol Lydia Wiediger
Nurse Practitioner - Psychiatric/Mental Health
3111 Electric Ave
Port Huron
, Michigan 48060-8127
Carol Lydia Wiediger
Nurse Practitioner - Psychiatric/Mental Health
3111 Electric Ave
Port Huron
, Michigan 48060-8127
(860) 297-0914
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About
Features
Specialties
- Nurse Practitioner - Psychiatric/Mental Health
Languages spoken
- English
Location
First Address
- Carol Lydia Wiediger
- 500 Vine Street Human Resources
- Hartford, CT
- Zip : 06112
- Fax : (860) 297-0914
- Phone : (860) 297-0905
Second Address
- Carol Lydia Wiediger
- 3111 Electric Ave
- Port Huron, MI
- Zip : 48060-8127
- Phone : (810) 985-8900
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 4704367059 | MI |
National Provider Identifier
| NPI | 1033285242 |
|---|---|
| Provider Name | Carol Lydia Wiediger |
| First Address | Hartford, CT 06112 |
| Second Address | Port Huron, MI 48060-8127 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/11/2006 |
| Last Update Date | 26/08/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| S36160 | (02) | CT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.