Bethany Wickson in Detroit - Nurse Practitioner
Bethany Wickson - NPI 1518087352
Bethany Wickson is a Nurse Practitioner in Detroit, Michigan. Bethany Wickson practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Bethany Wickson is 1518087352. The last update date is 2007-07-08.
Bethany Wickson's current location address is 4201 Saint Antoine St, Detroit, Michigan. You can contact this provider via phone number 3137453000. The mailing address for Bethany Wickson is 4201 Saint Antoine St, Detroit, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bethany Wickson |
|---|---|
| Address | 4201 Saint Antoine St, Detroit, Michigan |
| Phone Number | 3137453000 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | CNP |
NPI Number Detail
| NPI Number | 1518087352 |
|---|---|
| Provider Enumeration Date | 2007-03-29 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4201 Saint Antoine St |
|---|---|
| City | Detroit |
| State | Michigan (MI) |
| Post Code | 482012153 |
| Phone Number | 3137453000 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | 4704088774 |
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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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What is the Bethany Wickson's 1518087352?
The Bethany Wickson's NPI (National Provider Identifier) Number is 1518087352. 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 physical location address of Bethany Wickson?
The Bethany Wickson is physically situated at 4201 Saint Antoine St, in the city of Detroit, state of MI, with the postal code 482012153.
What is the Bethany Wickson's specialty and taxonomy code?
The Bethany Wickson's specialty is Nurse Practitioner, and the corresponding taxonomy code is 363L00000X.
On what date did Bethany Wickson receive its 1518087352 assignment from the Centers for Medicare & Medicaid Services?
The Bethany Wickson was assigned its 1518087352 on 2007-03-29, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Bethany Wickson last refreshed?
The information related to the Bethany Wickson, including its address, specialty, and other relevant details, was last updated on 2007-07-08.