Individual
KECIA A WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
301 WOLVERINE TRL, SUITE 100, SMYRNA, TN 37167-5656
(615) 459-6700
(615) 459-0068
Mailing address
PO BOX 520, WEST PADUCAH, KY 42086-0520
(270) 744-0404
(270) 744-0606
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN0000074758
TN
Other
Enumeration date
08/04/2006
Last updated
02/20/2008
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