Individual
MICHAEL WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 CHRISTOPHER LN, CLINTON, CT 06413-1830
(203) 200-8537
Mailing address
4 CHRISTOPHER LN, CLINTON, CT 06413-1830
(203) 200-8537
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12.017450
CT
Other
Enumeration date
05/25/2026
Last updated
05/25/2026
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