Individual
JACQUELINE NICOLE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
225 NATCHEZ TRACE AVE, BOWLING GREEN, KY 42103-7995
(270) 783-3573
(270) 783-4081
Mailing address
225 NATCHEZ TRACE AVE, BOWLING GREEN, KY 42103-7995
(270) 783-3573
(270) 783-4081
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007899
KY
Other
Enumeration date
02/08/2013
Last updated
08/02/2019
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