MRS. Mikayla D Wiese, PA-C

NPI #1912444258 in Hastings, Nebraska

Provider Information

NPI Number: 1912444258
Entity Type: Individual
Name: MRS. Mikayla D Wiese, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jan 25, 2017
Last Updated: Jan 25, 2017

Practice Location

Address: 715 N SAINT JOSEPH AVE
City: Hastings
State: Nebraska
ZIP Code: 68901-4451
Phone: (402) 461-4521

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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