Most Relevant Information
Provider Data
| NPI Number: | 1003363482 |
| Provider Name: | WENDY WIERSEMA LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 043037853 |
Most Important Dates
| Enumeration Date: | 09/02/2016 |
| Last Updated: | 09/02/2016 |
Provider Practice Location
325 IL ROUTE 2
DIXON
IL
610219118
Practice Location Phone/Fax
| Phone: | 8152846611 |
| Fax: |
Provider Mailing Location
25559 CLARK RD
CHADWICK
IL
610149289
Provider Mailing Phone/Fax
| Phone: | 8154999072 |
| Fax: |