Marilyn A Wiedemann
Registered Nurse, Administrator in San Diego, CA. Individual provider (NPI-1).
NPI number1164048682
StatusActive
Last updated in NPPESNov 27, 2023
Details
- NPI
- 1164048682
- Entity type
- Individual (NPI-1)
- Name
- Marilyn A Wiedemann
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 20, 2020
- Certification date
- Jun 20, 2020
- Last updated
- Nov 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WA2000X | Registered Nurse, Administrator | 244179 | CA | Yes |
Practice location
12089 Meriden LnSan Diego, CA 92128-4339
Phone 858-405-8502
Mailing address
12089 Meriden LnSan Diego, CA 92128-4339
Phone 858-405-8502
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