# JENNIFER FAE WILSBACHER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124278593
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 001931 | IA | — |
| 363A00000X | Physician Assistant | 1082489 | IA | Yes |

## Other

- **Enumeration date:** 09/23/2008
- **Last updated:** 05/08/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0057570 | — | IA |