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
ZIP Code
06349-2324
Phone
(860) 694-7521

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - FamilyFamily

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