Individual
ANN L WISSINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNCS
Contact information
Practice address
330 MOUNT AUBURN ST, CLARK 1, CAMBRIDGE, MA 02138-5502
(617) 499-5054
(617) 499-5465
Mailing address
ONE ARSENAL MARKETPLACE, WATERTOWN, MA 02472
(617) 673-1851
(617) 499-5579
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
117810
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00317875
RAILROAD MEDICARE
MA
01
—
PN0296
BLUE CROSS
MA
Enumeration date
11/20/2006
Last updated
07/08/2007
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