Eva Dominie Wilson
Nurse Practitioner - Gerontology
8198 Palmgren Ave Ne
Otsego
, Minnesota 55330-7224
Eva Dominie Wilson
Nurse Practitioner - Gerontology
8198 Palmgren Ave Ne
Otsego
, Minnesota 55330-7224
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Eva Dominie Wilson
- 8198 Palmgren Ave Ne
- Otsego, MN
- Zip : 55330-7224
- Phone :
Second Address
- Eva Dominie Wilson
- 8198 Palmgren Ave Ne
- Otsego, MN
- Zip : 55330-7224
- Phone : (763) 232-9877
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 8244 | MN |
National Provider Identifier
| NPI | 1063084127 |
|---|---|
| Provider Name | Eva Dominie Wilson |
| First Address | Otsego, MN 55330-7224 |
| Second Address | Otsego, MN 55330-7224 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/07/2021 |
| Last Update Date | 16/07/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.