Provider Demographics
NPI:1275200859
Name:WIESELER, CHRISTINE MARIE (DNP APRN, CPNP-PC/AC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:WIESELER
Suffix:
Gender:F
Credentials:DNP APRN, CPNP-PC/AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2259 COUNTY ROAD 16
Mailing Address - Street 2:
Mailing Address - City:COLON
Mailing Address - State:NE
Mailing Address - Zip Code:68018-4003
Mailing Address - Country:US
Mailing Address - Phone:402-216-9214
Mailing Address - Fax:
Practice Address - Street 1:11949 Q ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3503
Practice Address - Country:US
Practice Address - Phone:531-301-5022
Practice Address - Fax:531-365-3817
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113707363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics