Wiseman, Richard Goodman
Wiseman, Richard Goodman is an individual health care provider with primary practice located at 538 J M Ash Dr , Holly Springs MS 38635-3238. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Wiseman, Richard Goodman can be contacted via phone (662) 252-1599.Contact Information
Primary practice address
538 J M Ash Dr
Holly Springs MS 38635-3238
Phone: (662) 252-1599
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R549096 | Mississippi |
Profile Details
| NPI number | 1871690263 |
|---|---|
| LBN Legal business name | Wiseman, Richard Goodman |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1871690263 | NPPES |
| Mississippi | MEDICAID | 00114188 |
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