Individual
KANDALA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
720 W FOREST AVE, JACKSON, TN 38301-3904
(731) 541-1700
Mailing address
314 BEE FARM RD, LEXINGTON, TN 38351-6152
(731) 614-9713
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
38054
TN
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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