Wiley, Georgena D

Wiley, Georgena D is an individual health care provider with primary practice located at 4801 S Cooper St , Arlington TX 76017-5928. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Wiley, Georgena D can be contacted via phone (817) 557-8706.

Contact Information

Primary practice address
4801 S Cooper St Arlington TX 76017-5928
Phone: (817) 557-8706
Fax: (817) 557-8740
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 796624 California
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 22949 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP129659 Texas

Profile Details

NPI number 1346587680
LBN Legal business name Wiley, Georgena D
Credentials FNP-BC, RN
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 7th, 2013
Last updated Oct 22nd, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346587680 NPPES
Texas MEDICAID 1346587680
Texas MEDICAID 01062013391728

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