Provider Demographics
NPI:1518394220
Name:WISEMAN, ARRICK JAMES (RN)
Entity Type:Individual
Prefix:MR
First Name:ARRICK
Middle Name:JAMES
Last Name:WISEMAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 TURKEY FOOT RD
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-8605
Mailing Address - Country:US
Mailing Address - Phone:740-352-1890
Mailing Address - Fax:
Practice Address - Street 1:981 TURKEY FOOT RD
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-8605
Practice Address - Country:US
Practice Address - Phone:740-352-1890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH391923163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse