Provider Demographics
NPI:1164675153
Name:WREN, SAERI LEE (PA-C)
Entity Type:Individual
Prefix:
First Name:SAERI
Middle Name:LEE
Last Name:WREN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SAERI
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:201 TABERNACLE RD
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-2526
Mailing Address - Country:US
Mailing Address - Phone:828-257-6200
Mailing Address - Fax:
Practice Address - Street 1:201 TABERNACLE RD
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-2526
Practice Address - Country:US
Practice Address - Phone:828-257-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01564363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant