Wise, Lori Anne
Wise, Lori Anne is an individual health care provider with primary practice located at 4348 Electric Rd , Roanoke VA 24018-0720. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Wise, Lori Anne can be contacted via phone (540) 769-0976.Contact Information
Primary practice address
4348 Electric Rd
Roanoke VA 24018-0720
Phone: (540) 769-0976
Fax: (540) 857-5386
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 17778 | South Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 0024178297 | Virginia |
Profile Details
| NPI number | 1912096249 |
|---|---|
| LBN Legal business name | Wise, Lori Anne |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2006 |
| Last updated | Aug 8th, 2022 - about 4 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912096249 | NPPES |
| South Carolina | MEDICAID | NP2014 |
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