Individual provider · Type 1 NPI
Malissa R. Wightman, RN, APNP
Pediatric Nurse Practitioner · Beloit, WI
NPI number
1063631083
Active
Practice location
2825 Prairie Ave
Beloit, WI 53511-1844
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 1069 (WI) |
| Pediatric Nurse Practitioner | 363LP0200X | 113626 (WI) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1063631083
Malissa R. Wightman, RN, APNP's National Provider Identifier is 1063631083, issued on Apr 25, 2007. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Beloit, WI. The record was last updated on Jul 8, 2007.