Provider Demographics
NPI:1013934934
Name:WIESNER, BARBARA ANN (FNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:WIESNER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 BARNETT CIR
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-5807
Mailing Address - Country:US
Mailing Address - Phone:916-927-1114
Mailing Address - Fax:916-927-3244
Practice Address - Street 1:1 SCRIPPS DR
Practice Address - Street 2:#202
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6206
Practice Address - Country:US
Practice Address - Phone:916-927-1114
Practice Address - Fax:916-927-3244
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12986207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily