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Organization
MAGNOLIA MIND AND WELLNESS PLLC
Active
Organization
MAGNOLIA MIND AND WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA WISE PMHNP (OWNER)
(704) 396-5755
Entity
Organization
Contact information
Practice address
4263 POPLIN GROVE DR, INDIAN TRAIL, NC 28079-6877
(704) 396-5755
Mailing address
4263 POPLIN GROVE DR, INDIAN TRAIL, NC 28079-6877
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
Other
Enumeration date
10/09/2026
Last updated
10/09/2026
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