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Individual

MRS. COLLEEN LOUISE WISNOSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
13808 PROFESSIONAL CENTER DRIVE, HUNTERSVILLE, NC 28078-7948
(704) 377-4009
Mailing address
PO BOX 497, HUNTERSVILLE, NC 28070-0497
(704) 377-4009

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363AM0700X
Medical Physician Assistant
0010-01621
NC

Other

Enumeration date
12/13/2006
Last updated
07/12/2024
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