Provider Demographics
NPI:1598160871
Name:WISE CHOICE HEALTH CARE L.L.C.
Entity Type:Organization
Organization Name:WISE CHOICE HEALTH CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOATSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-NP
Authorized Official - Phone:308-221-6228
Mailing Address - Street 1:1220 S COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6113
Mailing Address - Country:US
Mailing Address - Phone:308-221-6228
Mailing Address - Fax:
Practice Address - Street 1:1220 S COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6113
Practice Address - Country:US
Practice Address - Phone:308-221-6228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty