Individual
KAITLYN WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W MEDICAL CENTER BLVD, WEBSTER, TX 77598-4220
(281) 338-3708
Mailing address
18215 HEREFORD LN, HOUSTON, TX 77058-3433
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1193511
TX
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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