Most Relevant Information
Provider Data
| NPI Number: | 1003384538 |
| Provider Name: | MAKENZIE WIESNER RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 195036-30 |
Most Important Dates
| Enumeration Date: | 11/02/2018 |
| Last Updated: | 11/02/2018 |
Provider Practice Location
401 W MICHIGAN ST APT 107
MILWAUKEE
WI
532032813
Practice Location Phone/Fax
| Phone: | 4142325599 |
| Fax: |
Provider Mailing Location
401 W MICHIGAN ST APT 107
MILWAUKEE
WI
532032813
Provider Mailing Phone/Fax
| Phone: | 4142325599 |
| Fax: |