Healthcare Provider Details

I. General information

NPI: 1275200859
Provider Name (Legal Business Name): CHRISTINE MARIE WIESELER DNP APRN, CPNP-PC/AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8552 CASS ST
OMAHA NE
68114-3567
US

IV. Provider business mailing address

8552 CASS ST
OMAHA NE
68114-3567
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-3871
  • Fax: 402-955-8738
Mailing address:
  • Phone: 402-955-3871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number113707
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number113707
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: