Individual
SHIANNE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12534 RUSSIAN OLIVE RD, JACKSONVILLE, FL 32218-3058
(570) 982-9735
Mailing address
12534 RUSSIAN OLIVE RD, JACKSONVILLE, FL 32218-3058
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/04/2026
Last updated
04/04/2026
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