Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK LARRY WISDOM, CSA
Active Sole ProprietorJACK LARRY WISDOM, CSA is a Registered Nurse healthcare provider located in PARADISE, California. NPI 1376968750 is currently active in the NPPES registry. Verify at CMS.
Registered Nurse · PARADISE, CA
Registration Details
- NPI Number
- 1376968750
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 21, 2014 (12.450959261258 yrs)
- Last Updated
- Feb 21, 2014
- Licenses
-
718316 (CA)96534 (TN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5974 PENTZ RDPARADISE, CA, 959695509Browse CA providers · Browse ZIP 95969
- Phone
- 5308767903
- Primary Specialty
-
Registered Nurse
163W00000X
- Additional Specialty
- Registered Nurse
Other Registered Nurse Providers in PARADISE, CA
| Name | Credential | NPI |
|---|---|---|
| MRS. PENELOPE ROSE FINN | RN | 1174685580 |
| MRS. KATHY LEA SEREDA | BSN RN | 1437295664 |
| MRS. MARY ANN PATRICE NEAL | R.N., P.H.N. | 1114109998 |
| MRS. STACEY KIZZIAR | RN | 1295988111 |
| MS. INSU HYAMS | — | 1063644862 |
| CYNTHIA EILEEN SIMS | — | 1639406077 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.