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Individual
JODI L WHEELER
Active
Individual
JODI L WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0106041
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P019010604
BLUE CHOICE #
NY
01
—
PA0454
PREFERRED CARE # FOR IM
NY
01
—
PA0455
PREFERRED CARE # FOR PEDS
NY
Enumeration date
05/03/2006
Last updated
06/15/2022
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