Individual
AUDRIE CHRISTINE WISELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
250 W 300 N, ROOSEVELT, UT 84066-2336
(435) 722-4691
Mailing address
PO BOX 794, ROOSEVELT, UT 84066-0794
(435) 733-0752
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6657212-405
UT
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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