Individual
TERESITA C WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.N.R.P.
Contact information
Practice address
9700 STONESTREET RD, LOUISVILLE, KY 40272-2884
(502) 995-2450
(502) 995-2464
Mailing address
5454 NEW CUT RD, SUITE 5, LOUISVILLE, KY 40214-4271
(502) 995-2450
(502) 995-2464
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
46780
KY
Other
Enumeration date
10/31/2008
Last updated
07/25/2012
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