Provider Demographics
NPI:1548026586
Name:WIEMAN, MORGAN VICTORIA (RN)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:VICTORIA
Last Name:WIEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:VICTORIA
Other - Last Name:STOCKDALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5687 CATHRO RD
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-9709
Mailing Address - Country:US
Mailing Address - Phone:715-505-5161
Mailing Address - Fax:
Practice Address - Street 1:400 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1434
Practice Address - Country:US
Practice Address - Phone:989-356-2161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704412461163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse