Individual
MRS. ROXOLANA LESYA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2415 MUSGROVE RD, SUITE 203, SILVER SPRING, MD 20904-5202
(301) 989-2300
(301) 236-5357
Mailing address
2415 MUSGROVE RD, SUITE 203, SILVER SPRING, MD 20904-5202
(301) 989-2300
(301) 236-5357
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA75548
MD
363LF0000X
Family Nurse Practitioner
F 2572
SC
Other
Enumeration date
06/14/2007
Last updated
06/26/2012
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