Individual
MS. CAROLYN R WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
6701 N CHARLES ST, DEPT OF SURGERY UNIT 48, BALTIMORE, MD 21204-6808
(443) 849-2350
Mailing address
PO BOX 631568, BALTIMORE, MD 21263-1568
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R052645
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KJ60/89502001
CAREFIRST MARYLAND GBMC
MD
01
—
S1250011
CAREFIRST REGIONAL GBMC
MD
Enumeration date
12/12/2006
Last updated
08/03/2007
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