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Individual

ASHLEY NICOLE WIESMANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3305 S 20TH ST STE 100, MILWAUKEE, WI 53215-4940
(414) 645-1984
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7494
WI
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100256724
WI
Enumeration date
02/28/2023
Last updated
02/19/2026
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