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Malissa R Wightman, RN,APNP
Pediatric Nurse Practitioner in Beloit, Wisconsin
NPI 1063631083

Malissa R Wightman is a Pediatric Nurse Practitioner based in Beloit, WI and is specialized in Pediatrics. Malissa R Wightman practices in Beloit, WI and has the professional credentials of RN,APNP. The NPI Number for Malissa R Wightman is 1063631083 and holds a License No. 1069 (Wisconsin).

The current practice location address for Malissa R Wightman is 2825 Prairie Ave, Beloit, WI and can be reached out via phone at 608-363-5500.

Location: 2825 Prairie Ave, Beloit, WI, 53511-1844
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063631083
Provider Name
Malissa R Wightman
Credential
RN,APNP
Provider Entity Type
Individual
Gender
Female
Address
2825 Prairie Ave, Beloit, WI, 53511-1844
Phone Number
608-363-5500
Fax Number
Provider Enumeration Date
04/25/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
43880300 05 WI
institution
Provider Business Practice Location Address Details
Address
2825 Prairie Ave
City
Beloit
State
Wisconsin
Zip
53511-1844
Phone Number
608-363-5500
Fax Number
person
Provider Business Mailing Address Details
Address
2825 Prairie Ave
City
Beloit
State
Wisconsin
Zip
53511-1844
Phone Number
608-363-5500
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
363LP0200X
License No.
1069 (Wisconsin)
Definition
Definition to come...
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