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Individual

MS. JENNIFER E WISEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, APN-C

Contact information

Practice address
1000 GALLOPING HILL ROAD, SUITE 106, SUMMIT, NJ 07901
(908) 598-7950
(908) 686-1163
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NN09300100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
223170423
FEDERAL TAX ID
Enumeration date
05/16/2006
Last updated
05/13/2025
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