Individual
MRS. SARA NICOLE WIESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNC
Contact information
Practice address
249 WYSS ST, JOHNSTOWN, CO 80534-7493
(970) 396-4039
Mailing address
249 WYSS ST, JOHNSTOWN, CO 80534-7493
(970) 396-4039
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
177265
CO
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
177265
CO
163WN0003X
Low-Risk Neonatal Registered Nurse
177265
CO
Other
Enumeration date
05/19/2012
Last updated
05/19/2012
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