Individual
DR. NICOLETTE CHRISTINE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(316) 268-5000
Mailing address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(316) 268-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
6966
KS
Other
Enumeration date
05/29/2008
Last updated
03/12/2014
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