Individual
MS. JESSICA KATHRYN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Mailing address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01098342A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01098342
LICENSE
IN
01
—
076217
CERTIFICATION
PA
01
—
1105908069
BCBS
IN
05
—
300124433
—
IN
05
—
7101114240
—
KY
Enumeration date
04/10/2019
Last updated
01/01/2026
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