Provider Demographics
NPI:1508620337
Name:WILEY, AISHIA MONIQUE (RN)
Entity Type:Individual
Prefix:
First Name:AISHIA
Middle Name:MONIQUE
Last Name:WILEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6450 ESCAPE RIDGE DR APT 102-8
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-1217
Mailing Address - Country:US
Mailing Address - Phone:540-998-7805
Mailing Address - Fax:
Practice Address - Street 1:6450 ESCAPE RIDGE DR APT 102-8
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-1217
Practice Address - Country:US
Practice Address - Phone:540-998-7805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001270095163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse