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

Individual provider Physician Assistant · NPI 1023399896

Lisa Marie Wilson, PA is a Physician Assistant in Myrtle Beach, South Carolina. Practices as a sole proprietor. Licensed in South Carolina.

Licensed in
SC
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

809 82nd Pkwy
Myrtle Beach, SC 29572-4607
Phone: (843) 497-5929
Fax: (843) 497-6601
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1687 (SC)

Record details

NPI number1023399896
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedSeptember 7, 2011
Last updated in NPPESMarch 20, 2017

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