| NPI | 1255638649 |
|---|---|
| Former Name | CAROLYN R. WISNIEWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP4886) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 145595) |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2022-07-21 |