Individual
ANDREA DAWN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1035 N EMPORIA AVE STE 105, WICHITA, KS 67214-2998
(800) 263-3366
Mailing address
1880 KENDRICK LN, EL DORADO, KS 67042-4064
(316) 734-0443
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
77871
KS
Other
Enumeration date
12/04/2017
Last updated
12/10/2024
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