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Individual

TAYLOR LEIGH WISNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, FNP-C, CPNP-PC

Contact information

Practice address
1100 CENTRAL AVE SE, PEDIATRIC CARE UNIT, ALBUQUERQUE, NM 87106-4930
(505) 841-1063
(505) 724-7042
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 841-1063

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
80557
NM
363LP0200X
Pediatric Nurse Practitioner
Primary
80557
NM

Other

Enumeration date
01/26/2021
Last updated
01/02/2025
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