Provider Demographics
NPI:1629440599
Name:WIMBISH, PATRICK (FNP-C)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:WIMBISH
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1262 E BROAD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-4902
Mailing Address - Country:US
Mailing Address - Phone:910-817-9200
Mailing Address - Fax:
Practice Address - Street 1:1262 E BROAD AVE
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4902
Practice Address - Country:US
Practice Address - Phone:910-817-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010981363LF0000X
TXAP129522363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily