Healthcare Provider Details

I. General information

NPI: 1558285668
Provider Name (Legal Business Name): SARAH ELIZABETH WISER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 2ND AVE
HUNTINGDON TN
38344-3806
US

IV. Provider business mailing address

PO BOX 400
JACKSON TN
38302-0400
US

V. Phone/Fax

Practice location:
  • Phone: 731-422-0213
  • Fax: 731-868-4766
Mailing address:
  • Phone: 731-425-5752
  • Fax: 731-256-7634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7359
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: