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General NPI Number Information
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NPI Number | 1760585335
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Entity Type | Individual
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Provider Name | QUYNH VU WISNIEWSKI MD
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Gender | Female
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 7557 A DANNAHER DR SUITE 130
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City | POWELL
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State | TN
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Zip | 37849
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Country | US
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Telephone | 865-689-1122
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Fax | 866-340-3781
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Provider Business Mailing Address
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Address Line | 7557 DANNAHER DR STE 130
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City | POWELL
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State | TN
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Zip | 37849-1509
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Country | US
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Telephone | 865-512-1180
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Fax | 865-512-1185
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 29093
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License Number State | TN
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