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General NPI Number Information
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NPI Number | 1427930478
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Entity Type | Individual
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Provider Name | MORIAH KIMBERLY WISE CPM, CLC
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Gender | Female
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 2401 DAWSON RD
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City | ALBANY
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State | GA
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Zip | 31707-2331
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Country | US
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Telephone | 229-349-4234
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Fax | 866-831-3234
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Provider Business Mailing Address
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Address Line | 606 MURPHY RD
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City | DAWSON
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State | GA
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Zip | 39842-4110
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Country | US
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Telephone | 229-261-3404
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Fax | 866-831-3234
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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