MEDICARE: ALLISAN WISNIEWSKI NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.17968	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639545551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISAN WISNIEWSKI NP-C

Provider Business Mailing Address
First Line	:	2200 JEFFERSON AVE
Second Line	:	5TH FLOOR
City	:	TOLEDO
State	:	OH
Zip	:	43604-7101
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2755 SHORELAND AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43611-1177
Country	:	US
Telephone Number	:	419-479-7000
Fax Number	:	419-473-9758

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2015
Last Update Date	:	10/12/2024

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