| Doctor Name: | MRS. KIMBERLY R. WISNIEWSKI |
| NPI Number: | 1003993007 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | VP006908M |
| Business Practice Address: | 321 Main St Suite 5 G Johnstown, PA - 159011632 |
| Business Phone Number: | 8145357721 |
| Business Fax Number: | 8145352105 |
| Mailing Address: | 321 Main St, Suite 5 G JOHNSTOWN |
| State: | PA |
| Postal Code: | 159011632 |
| Phone Number: | 8145357721 |
| Fax Number: | 8145352105 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | VP006908M |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |