Provider Demographics
NPI:1235927039
Name:WIX, KALEIGH (PA-S)
Entity type:Individual
Prefix:
First Name:KALEIGH
Middle Name:
Last Name:WIX
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 EVENING MIST DR APT 5104
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-2313
Mailing Address - Country:US
Mailing Address - Phone:770-361-4962
Mailing Address - Fax:
Practice Address - Street 1:406 EVENING MIST DR
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-2313
Practice Address - Country:US
Practice Address - Phone:770-361-4962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant