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:
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Health care specialties

SpecialtyCodeLicense #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 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912096249 NPPES
South Carolina MEDICAID NP2014

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