Individual
BONITA E WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
201 W 5TH ST, COOKEVILLE, TN 38501-1753
(931) 526-1688
(931) 372-0234
Mailing address
201 W 5TH ST, COOKEVILLE, TN 38501-1753
(931) 526-1688
(931) 372-0234
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN0000098800
TN
363LF0000X
Family Nurse Practitioner
6950
TN
Other
Enumeration date
07/27/2006
Last updated
12/15/2009
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