Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kimberly R Wisecup, DO

Individual provider Pediatrics Physician · NPI 1720469729

Kimberly R Wisecup, DO is a Pediatrics Physician in Las Vegas, Nevada. Works from 2 locations. Licensed in Nevada and Pennsylvania.

Licensed in
NV, PA
In the registry since
2015
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

3186 S Maryland Pkwy
Las Vegas, NV 89109-2306
Phone: (702) 961-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 500 University Dr, Hershey, PA 17033-0850 — (717) 531-8413

Specialties & licences

Neonatal-Perinatal Medicine Physician (primary) Taxonomy 2080N0001X · Licence DO3189 (NV)
Pediatrics Physician Taxonomy 208000000X · Licence OS019367 (PA)

Record details

NPI number1720469729
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 15, 2015
Last updated in NPPESJune 29, 2022
Certification dateJune 29, 2022
Mailing address3186 S Maryland Pkwy, Las Vegas, NV 89109-2306

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