Individual
RENAE LYNN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
630 SOUTHPOINTE CT, COLORADO SPRINGS, CO 80906-3896
(719) 289-3173
(866) 718-1677
Mailing address
630 SOUTHPOINTE CT, COLORADO SPRINGS, CO 80906-3896
(719) 289-3173
(866) 718-1677
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
C-APN.0001492-C-NP
CO
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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