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Individual

CAROLYN MARIE WISCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN, FNP-C

Contact information

Practice address
3001 S CONGRESS AVE STE 100, AUSTIN, TX 78704-6489
(512) 448-8686
(512) 464-8842
Mailing address
3003 LOCKE LN, AUSTIN, TX 78704-6135
(608) 792-0359

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
809564
TX
363LF0000X
Family Nurse Practitioner
Primary
AP142642
TX

Other

Enumeration date
10/21/2019
Last updated
10/21/2019
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