Individual
BREANA WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3103 E CARTWRIGHT AVE, FRESNO, CA 93725-9385
(559) 498-7100
Mailing address
1596 S TEMPERANCE AVE, FRESNO, CA 93727-6715
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
696496
CA
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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