Individual
JEFFREY SCOTT WIESEMAN
Active
Individual
JEFFREY SCOTT WIESEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, FNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN145013
GA
363LF0000X
Family Nurse Practitioner
Primary
APRN-NP145013
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003208071A
—
GA
01
—
06011176
AMERIGROUP
GA
01
—
1692220
WELLCARE
GA
Enumeration date
07/23/2018
Last updated
10/30/2025
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