Individual
KIRSTEN ELIZABETH WISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC, ACNP-BC
Contact information
Practice address
4996 E MEDITERRANEAN DR STE D, SIERRA VISTA, AZ 85635-2434
(520) 335-6271
(520) 335-6316
Mailing address
4996 E MEDITERRANEAN DR STE D, SIERRA VISTA, AZ 85635-2434
(520) 335-6271
(520) 335-6316
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
AP2534
AZ
363LF0000X
Family Nurse Practitioner
Primary
AP3956
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
610600
—
AZ
Enumeration date
07/09/2006
Last updated
07/17/2020
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