Individual
JACQUELINE DAWN WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
7600 CARROLL AVE, TAKOMA PARK, MD 20912-6367
(301) 891-7600
Mailing address
10508 EASTWIND WAY, COLUMBIA, MD 21044-5604
(410) 964-3235
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
098816
MD
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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