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Individual

JAKE WISENER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
UPMC HAMOT SCHOOL OF ANESTHESIA 201 STATE ST, ERIE, PA 16550-0001
(412) 291-0873
Mailing address
926 LIBERTY ST APT 2, ERIE, PA 16502-1263
(412) 291-0873

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN697386
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN697386
PA

Other

Enumeration date
06/24/2021
Last updated
05/13/2022
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