Marlene Mary Wilson
Nurse Practitioner Nurse Practitioner - Family Medicine
6745 Gray Rd Ste D
Indianapolis
, Indiana 46237-3236
Marlene Mary Wilson
Nurse Practitioner Nurse Practitioner - Family Medicine
6745 Gray Rd Ste D
Indianapolis
, Indiana 46237-3236
(317) 941-7254
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About
Features
Specialties
- Nurse Practitioner
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Marlene Mary Wilson
- Po Box 100
- Beech Grove, IN
- Zip : 46107-0100
- Fax : (317) 941-7254
- Phone : (317) 859-1090
Second Address
- Marlene Mary Wilson
- 6745 Gray Rd Ste D
- Indianapolis, IN
- Zip : 46237-3236
- Fax : (317) 941-7254
- Phone : (317) 859-1090
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 71000629A | IN |
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 71000629A | IN |
National Provider Identifier
| NPI | 1013062009 |
|---|---|
| Provider Name | Marlene Mary Wilson |
| First Address | Beech Grove, IN 46107-0100 |
| Second Address | Indianapolis, IN 46237-3236 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/01/2007 |
| Last Update Date | 08/11/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000033846 | M PLAN (01) | IN |
| 000000545372 | ANTHEM (01) | IN |
| 11533126 | CAQH (01) | IN |
| 200509870 | (05) | IN |
| 28086560A | RN LICENSE (01) | IN |
| 71000629B | CSR (01) | IN |
| ME0916645 | DEA (01) | IN |
| P00303828 | RAILROAD MEDICARE (01) | IN |
| P52133 | (02) | IN |
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.