Female

Julie L. Wisham PA

Physician Assistant in Jacksonville, FL(View on Map)

Full Name

Julie Lynn Wisham PA

NPI Number

1083397897

NPI Type

Individual Provider

Gender

Female

Enumeration Date

08/09/2023

Specialties

(Taxonomies)

Code

363A00000X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

1083397897

Contact
Information

Purpose

Mailing
Location

Address

11175 PARKSIDE PRESERVE WAY
3003 CLAIRE LN

City

Jacksonville
Jacksonville

State

FL
FL

Postal Code

32257-1562
32223-6665

Country

US
US

Telephone Number

(952) 913-7237
(407) 499-0515

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/26/2023

Provider Address

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