Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. LUCY NELSON WISDOM, MD
ActiveMRS. LUCY NELSON WISDOM, MD is a Dermatology healthcare provider located in BLOOMINGTON, Illinois. NPI 1669510400 is currently active in the NPPES registry. Verify at CMS.
Dermatology · BLOOMINGTON, IL
Registration Details
- NPI Number
- 1669510400
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 2, 2007 (19.556769157365 yrs)
- Last Updated
- Jul 8, 2007
- License
-
036110740 (IL)
Practice Information
- Address
-
1404 EASTLAND DRIVESUITE 204BLOOMINGTON, IL, 61701Browse IL providers · Browse ZIP 61701
- Phone
- 3096628813
- Fax
- 3096626835
- Primary Specialty
-
Dermatology
207N00000X
Other Dermatology Providers in BLOOMINGTON, IL
| Name | Credential | NPI |
|---|---|---|
| MR. RAJAGOPALA SWAMINATHAN | MD | 1528008414 |
| MR. THOMAS RICHARD BRANDER | MD | 1598803330 |
| MR. JAMES RICHARD SEEHAFER | MD | 1619015450 |
| DR. WYNN HUGH KAO | M.D., PH.D. | 1790996890 |
| ADRIENNE SCHUPBACH | M.D. | 1740415777 |
| NICHOLE CHRISTINE RAVE | PA-C | 1386031045 |
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.