| Doctor Name: | LUCY R WISEMON |
| NPI Number: | 1003976275 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNS-APN |
| License Number: | S01110 |
| Business Practice Address: | 4301 West 7th Little Rock, AR - 72205 |
| Business Phone Number: | 5012574840 |
| Business Fax Number: | |
| Mailing Address: | 7914 Standish Rd, LITTLE ROCK |
| State: | AR |
| Postal Code: | 722048360 |
| Phone Number: | 5015652951 |
| Fax Number: | |
| NPI Enumeration Date: | 12/11/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SA2100X |
| License Number: | S01110 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |