Individual
IRENE MANALISAY WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP RN
Contact information
Practice address
710 N BEAVER ST, BUILDING 6, FLAGSTAFF, AZ 86001-3100
(928) 527-4325
(928) 527-4327
Mailing address
710 N BEAVER ST, BUILDING 6, FLAGSTAFF, AZ 86001-3100
(928) 527-4325
(928) 527-4327
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP4241
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4733
—
AK
Enumeration date
02/13/2007
Last updated
03/07/2023
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