Individual provider · Type 1 NPI

Jaclyn Wise, PA-C

Physician Assistant · Fort Myers, FL

NPI number 1972806339 Active

Practice location

9617 Gulf Research Ln
Fort Myers, FL 33912-4560

Call (239) 418-0999 Map

Fax (239) 418-0091

Mailing address

953 Tidalwalk Dr
Wilmington, NC 28409-4968

Other practice locations

  • 2601 Iron Gate Dr, Wilmington, NC 28412-6625 · (910) 323-1545

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X0010-11679 (NC)
Physician Assistant Primary 363A00000XPA9120414 (FL)

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 1972806339

Jaclyn Wise, PA-C's National Provider Identifier is 1972806339, issued on Dec 7, 2010. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Fort Myers, FL. The record was last updated on Jan 28, 2026.