Individual
DIANA STEPHANIE WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 724-4133
Mailing address
55 FRUIT ST, YAWKEY CENTER SUITE 3B, BOSTON, MA 02114-2696
(617) 724-4133
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2287657
MA
363LA2200X
Adult Health Nurse Practitioner
AG06200288
MA
Other
Enumeration date
08/27/2020
Last updated
04/06/2026
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