DEMETIRUS LEGAIL WILSON NPI 1699250225

NPI Information

NPI: 1699250225
Provider Name: DEMETIRUS LEGAIL WILSON
Classification: Home Health Aide - 374U00000X
Entity Type: Individual
Address:
73 MALLARD HL
RINGGOLD, GA
ZIP 30736
Phone: (423) 503-4507
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Demetirus Legail Wilson is a home health aide in Ringgold, GA. The provider is a person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. Demetirus Legail Wilson NPI is 1699250225. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

73 MALLARD HL
RINGGOLD, GA
ZIP 30736-964
Phone: (423) 503-4507

The enumeration date for this NPI number is 9/28/2018 and was last updated on 9/28/2018.

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	374U00000X	Home Health Aide		066777	TENNESSEE	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	474763392	OTHER	TENNESSEE	CITY OF CHATTANOOGA

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: 5/5/2024

NPI Synchronization or Removal

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