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1740764075
AMY DIANE WILSON
COLUMBUS, IN
NPI
1740764075
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IN 71008369A)
Enumeration Date
2018-09-22
Last Update Date
2022-12-23
Business Address
AMY DIANE WILSON
2502 25TH ST
COLUMBUS, IN 47201-3728
Phone number: 812-372-8883
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Mailing Address
AMY DIANE WILSON
PO BOX 775383
CHICAGO, IL 60677-3728
Phone number: 812-376-5315
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