Individual
MARJORIE E WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3631 N MORRISON RD, MUNCIE, IN 47304-5547
(765) 281-3443
Mailing address
3631 N MORRISON RD, MUNCIE, IN 47304-5547
(765) 281-3443
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001347A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200379350
—
IN
01
—
P01014254
RR MEDICARE
IN
Enumeration date
03/14/2006
Last updated
03/29/2021
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