Individual
ALICIA JOY WISELEY-PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
20649 RIDER RD, IRONTON, MN 56455-2099
(218) 513-5999
Mailing address
20649 RIDER RD, IRONTON, MN 56455-2099
(218) 513-5999
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
160182-2
MN
Other
Enumeration date
05/04/2022
Last updated
05/04/2022
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