Provider Demographics
NPI:1437545803
Name:WISLER, SHEENA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:MARIE
Last Name:WISLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEENA
Other - Middle Name:MARIE
Other - Last Name:KAISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:715 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4209
Mailing Address - Country:US
Mailing Address - Phone:970-249-6737
Mailing Address - Fax:970-252-0112
Practice Address - Street 1:715 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4209
Practice Address - Country:US
Practice Address - Phone:970-249-6737
Practice Address - Fax:970-252-0112
Is Sole Proprietor?:No
Enumeration Date:2015-04-12
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODR.0061607207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program