Individual provider · Type 1 NPI

Jessica Danielle Keala Wise, DNP, CNM, PMHNP

Psychiatric/Mental Health Nurse Practitioner · Charlotte, NC

NPI number 1912413428 Active

Practice location

4412 Park Rd Ste B
Charlotte, NC 28209-3130

Mailing address

4412 Park Rd
Charlotte, NC 28209-3130

Other practice locations

  • 501 Billingsley Rd, Charlotte, NC 28211-1009 · (704) 358-2800

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X5020240 (NC)
Advanced Practice Midwife 367A00000XNone listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

7 other providers at this address

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About NPI 1912413428

Jessica Danielle Keala Wise, DNP, CNM, PMHNP's National Provider Identifier is 1912413428, issued on Dec 19, 2017. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Charlotte, NC. The record was last updated on Feb 10, 2026.