Provider Demographics
NPI:1124316013
Name:WISCHMEYER, STELLA EILEEN (CRNP, MSN, RN)
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:EILEEN
Last Name:WISCHMEYER
Suffix:
Gender:F
Credentials:CRNP, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 JENKINS DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7580
Mailing Address - Country:US
Mailing Address - Phone:610-923-0644
Mailing Address - Fax:
Practice Address - Street 1:1925 JENKINS DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-7580
Practice Address - Country:US
Practice Address - Phone:610-923-0644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011465363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health