Patricia A Wise

Individual provider Active NPI Private Vehicle · Ringgold, VA

NPI 1639726771 · NPPES record last updated Aug 22, 2019

Key facts

NPI
1639726771
Entity type
Individual (NPI type 1)
Primary specialty
Private Vehicle 347C00000X
License
WNN-1804 (VA)
Practice address
50 Oliver Dr
Ringgold, VA 24586-5704
Phone
(434) 709-6478
NPI assigned
Aug 22, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
WNN-1804VAMDPrivate Vehicle

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X WNN-1804 VA Yes

Addresses

Primary practice location

50 Oliver Dr
Ringgold, VA 24586-5704

Mailing address

50 Oliver Dr
Ringgold, VA 24586-5704
Phone (434) 709-6478

Other providers in Ringgold, VA

All providers in Ringgold, VA · Private Vehicle in Virginia

Sources for this page

Verify at the official NPI Registry.