Wisnasky, Krystle Michelle

Wisnasky, Krystle Michelle is an individual health care provider with primary practice located at 6812 State Route 162 Ste 200 , Maryville IL 62062-8562. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wisnasky, Krystle Michelle can be contacted via phone (618) 288-0900.

Contact Information

Primary practice address
6812 State Route 162 Ste 200 Maryville IL 62062-8562
Phone: (618) 288-0900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209.020939 Illinois

Profile Details

NPI number 1134753825
LBN Legal business name Wisnasky, Krystle Michelle
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2020
Last updated Mar 17th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134753825 NPPES
Illinois MEDICAID 209.020939

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