BERNICE WILSON NPI 1649458662

NPI Information

NPI: 1649458662
Provider Name: BERNICE WILSON
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
4202 BUELL DR
FORT WAYNE, IN
ZIP 46807
Phone: (260) 341-4756
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Bernice Wilson is a specialist in Fort Wayne, IN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Bernice Wilson NPI is 1649458662. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4202 BUELL DR
FORT WAYNE, IN
ZIP 46807-743
Phone: (260) 341-4756

The enumeration date for this NPI number is 1/31/2008 and was last updated on 1/31/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		32001561A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	32001561A	OTHER	INDIANA	COTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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