Healthcare Provider Details

I. General information

NPI: 1215757273
Provider Name (Legal Business Name): NASON WISE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 HUFFMAN MILL RD STE 2850
BURLINGTON NC
27215-8700
US

IV. Provider business mailing address

1236 HUFFMAN MILL RD STE 2850
BURLINGTON NC
27215-8700
US

V. Phone/Fax

Practice location:
  • Phone: 336-538-7482
  • Fax: 336-538-7291
Mailing address:
  • Phone: 336-538-7482
  • Fax: 336-538-7291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number700555
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1835C0206X
TaxonomyCardiology Pharmacist
License Number31482
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: