Ross Davin Wise, APRN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Fernandina Beach, FL
NPI 1194697284 · NPPES record last updated Sep 19, 2025
Key facts
- NPI
- 1194697284
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APRN11042360 (FL)
- Practice address
- 1896 S 14TH St Ste 6
Fernandina Beach, FL 32034-4416 - Phone
- (904) 310-9652
- Fax
- (904) 467-3143
- NPI assigned
- Sep 19, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11042360 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amelia Behavioral Wellness LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN11042360 | FL | Yes |
Addresses
Primary practice location
1896 S 14TH St Ste 6
Fernandina Beach, FL 32034-4416
Mailing address
523 Blue Daze St
Yulee, FL 32097-0087
Phone (904) 310-9652
Other providers in Fernandina Beach, FL
- William L Ross
- Kedra Fields Williams
- Tyler Andrew Wills
- Rosemary T Wilson
- Shelly Fulford Wilson
- Women'S Care Florida LLC
- Alana Woods
- Kathryn Worley
- Robert Thomas Wulterkens
- Yash P Sangwan M D P a
All providers in Fernandina Beach, FL · Psychiatric/Mental Health Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.