Individual
JULIE LYNN WISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7807 BAYMEADOWS RD E STE 303, JACKSONVILLE, FL 32256-9667
(904) 204-6585
Mailing address
11175 PARKSIDE PRESERVE WAY, JACKSONVILLE, FL 32257-1562
(952) 913-7237
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1083397897
FL
Other
Enumeration date
08/09/2023
Last updated
02/13/2026
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