Individual provider · Type 1 NPI
Lori Anne Wise, CPNP
Pediatric Nurse Practitioner · Roanoke, VA
NPI number
1912096249
Active
Practice location
4348 Electric Rd
Roanoke, VA 24018-0720
Fax (540) 857-5386
Mailing address
213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 17778 (SC) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 0024178297 (VA) |
Pediatric Nurse Practitioner: Definition to come...
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- Kylie Ann Tangney, CPNP-PCPediatric Nurse Practitioner Roanoke, VA NPI 1245879642
About NPI 1912096249
Lori Anne Wise, CPNP's National Provider Identifier is 1912096249, issued on Oct 12, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Roanoke, VA. The record was last updated on Aug 8, 2022.