Provider Demographics
NPI:1033982442
Name:WISHON, SARAH ELIZABETH (PA-C, MMSC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:WISHON
Suffix:
Gender:F
Credentials:PA-C, MMSC
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Mailing Address - Street 1:4243 GLENLAKE PKWY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-5198
Mailing Address - Country:US
Mailing Address - Phone:770-842-7066
Mailing Address - Fax:
Practice Address - Street 1:939 BOB ARNOLD BLVD STE F
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-3258
Practice Address - Country:US
Practice Address - Phone:770-769-1724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty