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Individual

ELIZABETH ANN MARIE WISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
556 SANDHURST DR, FAYETTEVILLE, NC 28304-4426
(910) 483-2646
Mailing address
9225 MAIN ST, GODWIN, NC 28344-8361
(910) 723-1072

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001011052
NC

Other

Enumeration date
02/17/2021
Last updated
05/05/2026
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