Individual provider · Type 1 NPI
Tristin Wisener
Student in an Organized Health Care Education/Training Program · Providence Village, TX
NPI number
1043841455
Active
Practice location
2140 Dewitt Ln
Providence Village, TX 76227-1425
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | None listed |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: 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.
About NPI 1043841455
Tristin Wisener's National Provider Identifier is 1043841455, issued on Feb 4, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Providence Village, TX. The record was last updated on Feb 4, 2020.