Doctor Name: | MS. DIEDRE ANN WISNIEWSKI |
NPI Number: | 1225341555 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 64342 |
Business Practice Address: | 400 Old Main Dr Summersville, WV - 266511360 |
Business Phone Number: | 3048723611 |
Business Fax Number: | 3048724626 |
Mailing Address: | 404 Old Main Dr, SUMMERSVILLE |
State: | WV |
Postal Code: | 266511360 |
Phone Number: | 3048723611 |
Fax Number: | 3048724626 |
NPI Enumeration Date: | 07/15/2010 |
NPI Last Update Date: | 07/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 64342 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |