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Individual
MRS. JANET LEAHY WILSON
Active
Individual
MRS. JANET LEAHY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-00422
NC
363A00000X
Physician Assistant
Primary
1825
SC
363AM0700X
Medical Physician Assistant
0010-00422
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-00422
NC MEDICAL LICENSE
NC
05
—
0825PA
—
SC
01
—
AA99506067
MEDICARE PIN
SC
01
—
AA99506084
MEDICARE PIN
SC
01
—
AA99508510
MEDICARE PIN
SC
01
—
AA99509068
MEDICARE PIN
SC
01
—
AA9950H918
MEDICARE PIN
SC
01
—
AA9950J577
MEDICARE PIN
SC
01
—
ME 1825
PHYSICIAN ASSISTANT LICENSE
SC
Enumeration date
03/26/2007
Last updated
03/07/2023
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