Kisha Nichella Wise, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN071397 Issued in GA

Practice address

370 Madeline Cir
Lawrenceville, GA 30043-3527

Phone

(770) 339-8057

Fax

(770) 339-8068

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942217393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 MADELINE CIR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433527",
            "telephone_number": "770-339-8057",
            "fax_number": "770-339-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 MADELINE CIR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433527",
            "telephone_number": "770-339-8057",
            "fax_number": "770-339-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KISHA",
        "middle_name": "NICHELLA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN071397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Winslow
• Kimberly Winston-Mickens, RN
• Alan Daniel Winston, M.D.
• Kereene Wint, FNP
• Matthew J Winters, DPT
• Brandy Wiseman, MA, LPC, NCC
• Christine Wilson Witter, FNP-C
• Esther Brooks Witter, CCC-SLP
• Gerrard Wofford
• Bersabell Hirut Woldetsadik

• Licensed Practical Nurse in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.