Healthcare Provider Details

I. General information

NPI: 1003922972
Provider Name (Legal Business Name): WISE COUNTY PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 LAKE ST
WISE VA
24293
US

IV. Provider business mailing address

PO BOX 1217
WISE VA
24293
US

V. Phone/Fax

Practice location:
  • Phone: 276-328-8017
  • Fax: 276-328-3350
Mailing address:
  • Phone: 276-328-8017
  • Fax: 276-328-3350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateVA
# 7
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number
License Number StateVA

VIII. Authorized Official

Name: MS. JERRIE H ADAMS
Title or Position: DIRECTOR SPECIAL EDUCATION STUDENT
Credential:
Phone: 276-328-8017