Individual provider · Type 1 NPI

John Anthony Wise, FNP-C

Family Nurse Practitioner · Southfield, MI

NPI number 1659828663 Active

Practice location

21540 W 11 Mile Rd, Ste 200
Southfield, MI 48076-3843

Fax (248) 352-8800

Mailing address

13033 Diversey St
Dearborn, MI 48126-1152

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X4704323970 (MI)
Family Nurse Practitioner 363LF0000X95002731 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1659828663

John Anthony Wise, FNP-C's National Provider Identifier is 1659828663, issued on Sep 7, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Southfield, MI. The record was last updated on Oct 6, 2016.