Individual
JESSICA LYNN WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
650 DICKINSON RD, CHESTERTON, IN 46304-3387
(219) 926-7755
(219) 929-1885
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-3616
(219) 364-3610
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28187239A
IN
363LF0000X
Family Nurse Practitioner
Primary
71007325A
IN
Other
Enumeration date
06/26/2017
Last updated
06/09/2021
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