Wizeman, Nicole A.

Wizeman, Nicole A. is an individual health care provider with primary practice located at 71 Haynes St , Manchester CT 06040-4131. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Wizeman, Nicole A. can be contacted via phone (860) 533-6595.

Contact Information

Primary practice address
71 Haynes St Manchester CT 06040-4131
Phone: (860) 533-6595
Fax: (860) 533-6594
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 3298 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA5251 Massachusetts

Profile Details

NPI number 1134511595
LBN Legal business name Wizeman, Nicole A.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2015
Last updated Jan 30th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134511595 NPPES
Connecticut Other 4686907 AETNA

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