| NPI | 1255764734 |
|---|---|
| Former Name | CHEILSA DAWN WIESNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 115170) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76108) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2024-02-20 |