Individual provider · Type 1 NPI

Nicole A. Wizeman, PA-C

Surgical Physician Assistant · Manchester, CT

NPI number 1134511595 Active

Practice location

71 Haynes St
Manchester, CT 06040-4131

Call (860) 533-6595 Map

Fax (860) 533-6594

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X3298 (CT)
Surgical Physician Assistant 363AS0400XPA5251 (MA)

Surgical Physician Assistant: Definition to come...

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About NPI 1134511595

Nicole A. Wizeman, PA-C's National Provider Identifier is 1134511595, issued on Feb 23, 2015. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Manchester, CT. The record was last updated on Jan 30, 2017.