Malissa R Wightman in Beloit - Pediatrics
Malissa R Wightman - NPI 1063631083
Malissa R Wightman is a Pediatrics in Beloit, Wisconsin. Malissa R Wightman practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Malissa R Wightman is 1063631083. The last update date is 2007-07-08.
Malissa R Wightman's current location address is 2825 Prairie Ave, Beloit, Wisconsin. You can contact this provider via phone number 6083635500. The mailing address for Malissa R Wightman is 2825 Prairie Ave, Beloit, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Malissa R Wightman |
|---|---|
| Address | 2825 Prairie Ave, Beloit, Wisconsin |
| Phone Number | 6083635500 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | RN, APNP |
NPI Number Detail
| NPI Number | 1063631083 |
|---|---|
| Provider Enumeration Date | 2007-04-25 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2825 Prairie Ave |
|---|---|
| City | Beloit |
| State | Wisconsin (WI) |
| Post Code | 535111844 |
| Phone Number | 6083635500 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 363Lp0200X |
| Licence No | 1069 |
|
Definition: An advanced practice registered nurse expert in providing care to infants, children and adolescents. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 43880300 | WI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Malissa R Wightman by the Centers for Medicare & Medicaid Services (CMS)?
The Malissa R Wightman has been assigned the NPI (National Provider Identifier) 1063631083. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete physical location address of Malissa R Wightman?
The Malissa R Wightman is physically situated at 2825 Prairie Ave, in the city of Beloit, state of WI, with the postal code 535111844.
What is Malissa R Wightman's area of expertise and its corresponding taxonomy classification?
The Malissa R Wightman's field of specialization is Pediatrics, and it falls under the taxonomy code 363Lp0200X, which categorizes healthcare providers based on their areas of practice.
On what date did the Malissa R Wightman receive its 1063631083 assignment from the Centers for Medicare & Medicaid Services?
The Malissa R Wightman was assigned its 1063631083 by the Centers for Medicare & Medicaid Services on 2007-04-25.
When was the Malissa R Wightman's information last updated?
The Malissa R Wightman's information was last updated on 2007-07-08.
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