Individual
CARISSA WIESELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14441 DUPONT CT STE 304, OMAHA, NE 68144-2107
(402) 597-8775
Mailing address
14441 DUPONT CT STE 304, OMAHA, NE 68144-2107
(402) 597-8775
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
36221
NE
2085R0202X
Diagnostic Radiology Physician
73126
MN
2085R0202X
Diagnostic Radiology Physician
TRN28156
FL
Other
Enumeration date
05/07/2018
Last updated
07/23/2024
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