Individual
CORI WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
2100 E COLORADO BLVD STE 1, PASADENA, CA 91107
(626) 229-9865
(626) 229-9867
Mailing address
3531 HONOLULU AVE, GLENDALE, CA 91214-3221
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
693452
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
18565
CA
363LA2100X
Acute Care Nurse Practitioner
AP61079067
WA
Other
Enumeration date
11/24/2008
Last updated
02/17/2022
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