Individual
TARA WIESNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,CCM
Contact information
Practice address
12337 JONES RD STE 100, HOUSTON, TX 77070-4844
(303) 570-0134
(877) 747-9662
Mailing address
1852 PARKDALE CIR S, ERIE, CO 80516-2407
(720) 933-3039
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
0140447
CO
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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