Individual
DR. HEIDI E WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1501 PINE LAKE RD, SUITE 1, LINCOLN, NE 68512-3692
(402) 421-7773
(402) 421-7859
Mailing address
1501 PINE LAKE RD, SUITE 1, LINCOLN, NE 68512-3692
(402) 421-7773
(402) 421-7859
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1124
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100249863-00
—
NE
Enumeration date
08/18/2005
Last updated
07/08/2007
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