Individual
LOURDES WISNIEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
19 DAVIS AVE, NEPTUNE, NJ 07753-4488
(732) 897-3870
Mailing address
19 DAVIS AVE FL 4, NEPTUNE, NJ 07753-4488
(732) 897-3870
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
26NJ14942200
NJ
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ14942200
NJ
Other
Enumeration date
10/20/2023
Last updated
04/05/2024
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