Provider Demographics
NPI:1437678737
Name:WESEMAN, ANNALISA (APRN-FNP)
Entity Type:Individual
Prefix:
First Name:ANNALISA
Middle Name:
Last Name:WESEMAN
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4619 SUNFLOWER RD APT 158
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1461
Mailing Address - Country:US
Mailing Address - Phone:865-292-8860
Mailing Address - Fax:
Practice Address - Street 1:4619 SUNFLOWER RD APT 158
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1461
Practice Address - Country:US
Practice Address - Phone:865-292-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23354363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily