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Individual

DR. KRISTINE ELIZABETH WIESE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2277 HIGHWAY 36 W, ROSEVILLE, MN 55113-3804
(612) 255-0628
(612) 255-0647
Mailing address
PO BOX 2182, BURNSVILLE, MN 55337-0008
(612) 670-1321

Taxonomy

Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
39360
MN

Other

Enumeration date
07/23/2006
Last updated
07/21/2022
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