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NPI Code Detail

MEDICARE: VICTORIA ALANE WISE CNP

MEDICARE: VICTORIA ALANE WISE CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN.439782OH
2363LF0000XFamily Nurse PractitionerAPRN.CNP.0033724OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CB6624OTHERRAILROAD MEDICARE GROUP NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
45374990001OTHERDMERC REGION B

General Provider Information

NPI Number : 1538850888
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA ALANE WISE CNP
Provider Business Mailing Address
First Line : 1138 W HIGH ST
Second Line :
City : LIMA
State : OH
Zip : 45805-2725
Country : US
Telephone Number : 419-225-2726
Fax Number : 419-228-9909
Provider Business Practice Location Address
First Line : 1138 W HIGH ST
Second Line :
City : LIMA
State : OH
Zip : 45805-2725
Country : US
Telephone Number : 419-225-2726
Fax Number : 419-228-9909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2023
Last Update Date : 08/21/2023

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Directions to “ VICTORIA ALANE WISE CNP” Practice Location

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