P Lynn Wiseman, CNS | |
200 Crescent Centre Park, Department Of Behavioral Health, Tucker, GA 30084 | |
(770) 496-3609 | |
(770) 496-3708 |
Full Name | P Lynn Wiseman |
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Gender | Female |
Speciality | Clinical Nurse Specialist - Psychiatric/mental Health |
Location | 200 Crescent Centre Park, Tucker, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336241371 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
364SP0808X | Clinical Nurse Specialist - Psychiatric/mental Health | RN126821 (Georgia) | Primary |
Entity Name | The Southeast Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
Mailing Address | Practice Location Address |
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P Lynn Wiseman, CNS 3495 Piedmont Road Ne, Nine Piedmont Center, Atlanta, GA 30305-1736 Ph: (404) 364-7000 | P Lynn Wiseman, CNS 200 Crescent Centre Park, Department Of Behavioral Health, Tucker, GA 30084 Ph: (770) 496-3609 |
Alice D Mintz, CNS Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 200 Crescent Centre Park, Department Of Behavioral Health, Tucker, GA 30084 Phone: 770-496-3609 Fax: 770-496-3708 | |
Debra Elizabeth Rhiver, A.P.R.N., B.C. Clinical Nurse Specialist Medicare: Accepting Medicare Assignments Practice Location: 2625 Salem Xing, Tucker, GA 30084 Phone: 678-248-4346 | |
Jane M Kerner-mendoza, CNS Clinical Nurse Specialist Medicare: Not Enrolled in Medicare Practice Location: 200 Crescent Centre Parkway, Department Of Behavioral Health, Tucker, GA 33084 Phone: 770-496-3609 Fax: 770-496-3708 |