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1942217393
KISHA NICHELLA WISE
LAWRENCEVILLE, GA
NPI
1942217393
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: GA LPN071397)
Enumeration Date
2006-08-01
Last Update Date
2007-07-08
Business Address
MRS. KISHA NICHELLA WISE LPN
370 MADELINE CIR
LAWRENCEVILLE, GA 30043-3527
Phone number: 770-339-8057
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Mailing Address
MRS. KISHA NICHELLA WISE LPN
370 MADELINE CIR
LAWRENCEVILLE, GA 30043-3527
Phone number: 770-339-8057
Copy
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