Individual
HANNAH KATHRYN WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 BUFFALO GROVE PL, PALM COAST, FL 32137-9462
(386) 283-1972
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9120291
FL
363AS0400X
Surgical Physician Assistant
PA9120291
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127463100
—
FL
01
—
FRZOH
BCBS
FL
Enumeration date
02/06/2023
Last updated
12/07/2025
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