Provider Demographics
NPI:1538215769
Name:WISE, AYSE BOSWELL (PMHNP, WHNP, RN-C)
Entity type:Individual
Prefix:
First Name:AYSE
Middle Name:BOSWELL
Last Name:WISE
Suffix:
Gender:F
Credentials:PMHNP, WHNP, RN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S PERIMETER PARK DR
Mailing Address - Street 2:STE 210
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4143
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4709 PAPERMILL DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1921
Practice Address - Country:US
Practice Address - Phone:865-525-0391
Practice Address - Fax:865-381-1969
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8449363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health