Mary Deborah Wilson in Berlin - Nurse Practitioner
Mary Deborah Wilson - NPI 1306051313
Mary Deborah Wilson is a Nurse Practitioner in Berlin, Maryland. Mary Deborah Wilson practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Mary Deborah Wilson is 1306051313. The last update date is 2020-06-12.
Mary Deborah Wilson's current location address is 11022 Nicholas Ln, Berlin, Maryland. You can contact this provider via phone number 4106415190 and fax number 4106415463. The mailing address for Mary Deborah Wilson is 11022 Nicholas Ln, Berlin, Maryland. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Deborah Wilson |
|---|---|
| Address | 11022 Nicholas Ln, Berlin, Maryland |
| Phone Number | 4106415190 |
| Fax Number | 4106415463 |
| Sole Proprietor | Y |
| Credentials | PMHNP-BC |
NPI Number Detail
| NPI Number | 1306051313 |
|---|---|
| Provider Enumeration Date | 2007-05-12 |
| Last Updated Date | 2020-06-12 |
Provider Mailing Address Detail
| Address | 11022 Nicholas Ln |
|---|---|
| City | Berlin |
| State | Maryland (MD) |
| Post Code | 218113352 |
| Phone Number | 4106415190 |
| Fax Number | 4106415463 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | R056757 |
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Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 609550001 | MD | -- | |
| 517251 | MD | OPTUM | |
| 346646 | MD | MANAGED HEALTH NET/TRICARE | |
| 259147-000 | MD | MAGELLAN BEHAVIORAL HEALTH | |
| 609550004 | MD | -- | |
| 499188 | MD | BEACON HEALTH OPTIONS | |
| 609550002 | MD | -- | |
| 7840093 | MD | AETNA | |
| R968 | MD | CAREFIRST OF MARYLAND |
Post Comment/ Review Below
What is the Mary Deborah Wilson's 1306051313?
The Mary Deborah Wilson's NPI (National Provider Identifier) Number is 1306051313. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Mary Deborah Wilson is physically located?
The Mary Deborah Wilson is physically situated at the following address: 11022 Nicholas Ln, Berlin, MD, 218113352.
What is the Mary Deborah Wilson's specialty and taxonomy code?
The Mary Deborah Wilson's specialty is Nurse Practitioner, and the corresponding taxonomy code is 363L00000X.
When did the Mary Deborah Wilson receive its 1306051313?
The Mary Deborah Wilson was issued its 1306051313 on 2007-05-12, which is the date when the organization was assigned this unique identifier.
When was the Mary Deborah Wilson's information last updated?
The Mary Deborah Wilson's information was last updated on 2020-06-12.