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NPI Code Detail

MEDICARE: MS. STEPHANIE M WISE APRN

MEDICARE: MS. STEPHANIE M WISE APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN9198747FL
2363LF0000XFamily Nurse PractitionerAPRN9198747FL

General Provider Information

NPI Number : 1508149048
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEPHANIE M WISE APRN
Provider Business Mailing Address
First Line : 7240 7TH PL N
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33411-3801
Country : US
Telephone Number : 561-969-6663
Fax Number : 561-721-3106
Provider Business Practice Location Address
First Line : 7240 7TH PL N
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33411-3801
Country : US
Telephone Number : 561-969-6663
Fax Number : 561-721-3106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2011
Last Update Date : 05/02/2023

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