Provider Demographics
NPI:1205470747
Name:WISEMAN, APRIL (PA-C)
Entity type:Individual
Prefix:MS
First Name:APRIL
Middle Name:
Last Name:WISEMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 BRIARDALE DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-2037
Mailing Address - Country:US
Mailing Address - Phone:972-762-1942
Mailing Address - Fax:
Practice Address - Street 1:7777 FOREST LN STE C755
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-6862
Practice Address - Country:US
Practice Address - Phone:972-566-2600
Practice Address - Fax:972-566-2121
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13142363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant