MEDICARE: LISA WHEELER NP

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
1	363L00000X	Nurse Practitioner	0024171519	VA
2	363LA2100X	Acute Care Nurse Practitioner	0024171519	VA

General Provider Information

NPI Number	:	1699187211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA WHEELER NP

Provider Business Mailing Address
First Line	:	7515 HOOFPRINT LN
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-6432
Country	:	US
Telephone Number	:	804-241-3452
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 BROAD ROCK BLVD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23249-5051
Country	:	US
Telephone Number	:	804-675-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	02/27/2025

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