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Individual

BARBARA V WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
1302 BELLONA AVE, LUTHERVILLE, MD 21093-5425
(667) 214-2200
(410) 706-5103
Mailing address
PO BOX 62063, BALTIMORE, MD 21263-2063
(410) 706-5181
(410) 706-5103

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R057734
MD

Other

Enumeration date
11/14/2008
Last updated
04/06/2017
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