Malissa D Wickersham, FNP
NPI #1992005623 in Groton, Connecticut
Provider Information
- NPI Number
- 1992005623
- Entity Type
- Individual
- Name
- Malissa D Wickersham, FNP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner - Family
- Credential
- FNP
- Enumeration Date
- Oct 28, 2010
- Last Updated
- Nov 18, 2019
Practice Location
- Address
- 1 WAHOO AVE
- City
- Groton
- State
- Connecticut
- ZIP Code
- 06349-2324
- Phone
- (860) 694-7521
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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