Individual
MS. MARY FELICIA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
164441-30
WI
363L00000X
Nurse Practitioner
10008-33
WI
363LP2300X
Primary Care Nurse Practitioner
Primary
10008-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100104639
—
WI
Enumeration date
03/12/2009
Last updated
07/03/2024
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