Individual
PATSY WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1252 E QUINCY ST, BROKEN ARROW, OK 74012-5637
(918) 261-4439
(877) 992-9262
Mailing address
1252 E QUINCY ST, BROKEN ARROW, OK 74012-5637
(918) 261-4439
(877) 992-9262
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
58539
OK
363L00000X
Nurse Practitioner
Primary
58539
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200673190
—
OK
Enumeration date
12/07/2015
Last updated
07/21/2022
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