Individual
MR. ROSS DAVIN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1896 S 14TH ST STE 6, FERNANDINA BEACH, FL 32034-4416
(904) 310-9652
(904) 467-3143
Mailing address
523 BLUE DAZE ST, YULEE, FL 32097-0087
(904) 310-9652
(904) 467-3143
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11042360
FL
Other
Enumeration date
09/19/2025
Last updated
09/19/2025
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