Individual provider · Type 1 NPI
Carolyn Marie Wiese, PA
Physician Assistant · Petoskey, MI
Practice location
3890 Charlevoix Rd Ste 307
Petoskey, MI 49770-9719
Mailing address
743 E Beltline Ave NE
Grand Rapids, MI 49525-6045
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA001143 (ME) |
| Physician Assistant Primary | 363A00000X | 5601003704 (MI) |
Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…
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About NPI 1235130576
Carolyn Marie Wiese, PA's National Provider Identifier is 1235130576, issued on Aug 9, 2005. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Petoskey, MI. The record was last updated on Aug 31, 2026.