Provider Demographics
NPI:1043381528
Name:WISEMAN, CLAUDIA (NMNP)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:WISEMAN
Suffix:
Gender:F
Credentials:NMNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65465 CLINE FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-8113
Mailing Address - Country:US
Mailing Address - Phone:541-617-4774
Mailing Address - Fax:541-617-4770
Practice Address - Street 1:412 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2209
Practice Address - Country:US
Practice Address - Phone:541-617-4774
Practice Address - Fax:541-617-4770
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200650054NP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife