Individual
ANDREA MI WILD-GINGELESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
582 BLUE RIDGE AVE, BEDFORD, VA 24523-2604
(434) 455-2480
Mailing address
134 ELON RD, MADISON HEIGHTS, VA 24572-2536
(434) 455-2480
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024181709
VA
Other
Enumeration date
07/31/2021
Last updated
02/29/2024
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