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General NPI Number Information
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NPI Number | 1013944339
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Entity Type | Individual
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Provider Name | RITA KATHRYN WISE ARNP, MSN
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Gender | Female
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 417 GREYWOLF RD
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City | SEQUIM
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State | WA
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Zip | 98382-7573
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Country | US
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Telephone | 360-582-9233
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Fax | 360-582-9233
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Provider Business Mailing Address
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Address Line | 417 GREYWOLF RD
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City | SEQUIM
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State | WA
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Zip | 98382-7573
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Country | US
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Telephone | 360-582-9233
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Fax | 360-582-9233
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | AP30006988
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60005736
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP30006988
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN00158838
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License Number State | WA
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