Individual provider Active NPI

Stephanie Angela Wiseman

  • Nurse Practitioner
  • Princeton, WV
National Provider Identifier
1316879216
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
126707 Issued in WV
Practice address
218 Undercliff Ter
Princeton, WV 24740-2176
Phone
(304) 327-1890
NPI assigned
Jun 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 126707 WV Primary

Addresses

Primary practice location

218 Undercliff Ter
Princeton, WV 24740-2176

Mailing address

218 Undercliff Ter
Princeton, WV 24740-2176
Phone (304) 327-1890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

218 Undercliff Ter
Princeton, WV 24740-2176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
97569WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert W Edwards III MD Inc CurrentSince Jun 15, 2026 Accepting new patients

Locations

488 Cherry St
Ste 2
Bluefield, WV 24701
Phone (304) 324-8470

218 Undercliff Ter
Princeton, WV 24740
Phone (304) 327-1890

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1316879216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 UNDERCLIFF TER",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402176",
            "telephone_number": "304-327-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 UNDERCLIFF TER",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402176",
            "telephone_number": "304-327-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "STEPHANIE",
        "middle_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-02",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "126707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.