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General NPI Number Information
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NPI Number | 1801519186
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Entity Type | Individual
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Provider Name | DANIEL J WISE RN
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Gender | Male
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Dates
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Enumeration Date | 09/22/2022
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 821 W MIDLAND RD
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City | AUBURN
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State | MI
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Zip | 48611-9200
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Country | US
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Telephone | 989-450-5579
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Fax |
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Provider Business Mailing Address
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Address Line | 821 W MIDLAND RD
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City | AUBURN
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State | MI
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Zip | 48611-9200
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Country | US
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Telephone | 989-450-5579
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Fax |
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 4704217949
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License Number State | MI
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