Individual
KIMBERLY WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
750 EAST ADAMS STREET, SYRACUSE, NY 13210
(315) 464-5450
(315) 464-6322
Mailing address
251 SALINA MEADOWS PARKWAY, SUITE 100, SYRACUSE, NY 13212
(315) 464-2000
(315) 464-2010
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
382971
NY
363LP0200X
Pediatric Nurse Practitioner
RN2332955
MA
363LP0200X
Pediatric Nurse Practitioner
RN233955
MA
Other
Enumeration date
11/10/2019
Last updated
05/28/2024
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