Individual
MS. TRACY WISSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN-BC, NP-C
Contact information
Practice address
92 2ND ST, HACKENSACK, NJ 07601-2191
(551) 996-5900
Mailing address
692 OAK AVE, MAYWOOD, NJ 07607-1514
(201) 712-0043
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20NJ00514500
NJ
Other
Enumeration date
08/17/2014
Last updated
08/17/2014
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