Provider Demographics
NPI:1982239547
Name:WEDDLE, MAE ARMER (ACNP)
Entity type:Individual
Prefix:MS
First Name:MAE
Middle Name:ARMER
Last Name:WEDDLE
Suffix:
Gender:
Credentials:ACNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-362-1291
Mailing Address - Fax:314-996-3268
Practice Address - Street 1:1020 N MASON RD
Practice Address - Street 2:DIV IM CARDIOLOGY, STE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6666
Practice Address - Country:US
Practice Address - Phone:314-362-1291
Practice Address - Fax:314-996-3268
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020007750363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420082644Medicaid