Individual
ANDREA SHAWN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
3600 FREDERICA ST, OWENSBORO, KY 42301-6981
(270) 684-0023
(270) 684-0065
Mailing address
3600 FREDERICA ST, OWENSBORO, KY 42301-6981
(270) 684-0023
(270) 684-0065
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3017990
KY
363LF0000X
Family Nurse Practitioner
3017990
KY
Other
Enumeration date
06/27/2022
Last updated
07/15/2025
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