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Individual

JOANNA WISHART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
6600 VAN AALST BLVD, FORT BENNING, GA 31905-2102
(762) 408-0374
Mailing address
6600 VAN AALST BLVD, FORT BENNING, GA 31905-2102
(762) 408-0374

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
140775
TX
363LF0000X
Family Nurse Practitioner
95026505
CA
363LF0000X
Family Nurse Practitioner
Primary
RN263430
GA

Other

Enumeration date
04/12/2019
Last updated
05/17/2025
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