Provider Demographics
NPI:1255119111
Name:WUISCHPARD, DAVID LEWIS (RN)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LEWIS
Last Name:WUISCHPARD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 DIZZY CT
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29575-8646
Mailing Address - Country:US
Mailing Address - Phone:574-344-1011
Mailing Address - Fax:
Practice Address - Street 1:1008 DIZZY CT
Practice Address - Street 2:
Practice Address - City:SURFSIDE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29575-8646
Practice Address - Country:US
Practice Address - Phone:574-344-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC269692163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health