Provider Demographics
NPI:1699462796
Name:WHEELER, AISHA LYNN (FNP)
Entity type:Individual
Prefix:
First Name:AISHA
Middle Name:LYNN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:AISHA
Other - Middle Name:LYNN
Other - Last Name:EVERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:832 11TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-2149
Mailing Address - Country:US
Mailing Address - Phone:509-254-4289
Mailing Address - Fax:
Practice Address - Street 1:1331 G ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-1964
Practice Address - Country:US
Practice Address - Phone:208-743-9616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID62125163WG0000X, 363LF0000X
WARN60956418163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice