Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carolyn Marie Wiese, PA

Individual provider Medical Physician Assistant · NPI 1235130576

Carolyn Marie Wiese, PA is a Physician Assistant in Petoskey, Michigan. Qualified in 2001, 25 years ago. Practices with Petoskey Family Medicine, PC, a 5-clinician group and accepts Medicare assignment. Licensed in Maine and Michigan.

Years since qualifying
25
Licensed in
ME, MI
In the registry since
2005
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

2390 Mitchell Park Dr Ste D
Petoskey, MI 49770
Phone: (231) 487-7200
Fax: (231) 487-7188
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601003704 (MI)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA001143 (ME)

Record details

NPI number1235130576
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 9, 2005
Last updated in NPPESJune 12, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Petoskey Family Medicine, P.C. — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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