Individual
MRS. PERIANN G WASIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1000 CEDAR ST, HOUGHTON, MI 49931-1978
(906) 487-1710
(906) 487-9421
Mailing address
1000 CEDAR ST, HOUGHTON, MI 49931-1978
(906) 487-1710
(906) 487-9421
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704202376
MI
363LF0000X
Family Nurse Practitioner
Primary
4704202376
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704202376
LICENSE
—
01
—
PW202376
BCBS LICENSE NUMBER
MI
Enumeration date
10/02/2006
Last updated
10/31/2014
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