Individual
LIBBI WISSEKERKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4000
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01129
RI
363A00000X
Physician Assistant
PA8171
MA
Other
Enumeration date
04/01/2019
Last updated
12/15/2025
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