Individual provider · Type 1 NPI
Lisa Marie Wild-Gingeleski, NP
Psychiatric/Mental Health Nurse Practitioner · Roanoke, VA
NPI number
1649192113
Active
Practice location
4511 Peach Tree Dr NW
Roanoke, VA 24017-2021
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 0024198166 (VA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1649192113
Lisa Marie Wild-Gingeleski, NP's National Provider Identifier is 1649192113, issued on Jul 28, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Roanoke, VA. The record was last updated on Jul 28, 2026.