Individual
MRS. MICHELLE TONIA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
0001156324
VA
363LN0000X
Neonatal Nurse Practitioner
0024156324
VA
363LN0005X
Critical Care Neonatal Nurse Practitioner
0024156324
VA
363LP0200X
Pediatric Nurse Practitioner
Primary
0024156324
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1946661466
—
VA
Enumeration date
04/01/2006
Last updated
08/07/2026
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