Individual
MADELINE LEE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
30 HUNTER LN, CAMP HILL, PA 17011-2499
(717) 763-1181
Mailing address
19128 112TH AVE NE APT 619, BOTHELL, WA 98011-0023
(708) 305-4614
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
61059819
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61059819
RN LICENSE
WA
Enumeration date
06/12/2021
Last updated
06/12/2021
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