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General NPI Number Information
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NPI Number | 1508572322
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Entity Type | Individual
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Provider Name | LINDSEY RENEE WISE PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/25/2023
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 3235 SW 34TH ST STE 101
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City | OCALA
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State | FL
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Zip | 34474-7502
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Country | US
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Telephone | 800-457-4573
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Fax |
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Provider Business Mailing Address
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Address Line | 911 HUBBARD LOOP
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City | THE VILLAGES
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State | FL
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Zip | 32163-0605
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Country | US
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Telephone | 734-693-4520
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704315809
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11023667
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License Number State | FL
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