Individual
MICHELE MAE WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1617 SHERMAN AVE, MADISON, WI 53704-5930
(608) 245-3094
(608) 245-3879
Mailing address
1617 SHERMAN AVE, MADISON, WI 53704-5930
(608) 245-3094
(608) 245-3879
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
150581-30
WI
363L00000X
Nurse Practitioner
Primary
6411-33
WI
Other
Enumeration date
06/19/2015
Last updated
06/05/2020
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