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General NPI Number Information
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NPI Number | 1134644982
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Entity Type | Individual
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Provider Name | AMY MICHELLE WISE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/13/2017
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 4300 W 7TH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5446
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Country | US
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Telephone | 501-257-6707
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Fax | 501-257-6606
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Provider Business Mailing Address
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Address Line | 4300 W 7TH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5446
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Country | US
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Telephone | 501-257-6707
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Fax | 501-257-6606
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 227153
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License Number State | AR
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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 | 22916
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License Number State | TN
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