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Individual

NORMA D. WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-9099
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD, SUITE #301, ALLENTOWN, PA 18103-6258
(610) 402-9099
(610) 402-9029

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN247004L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
047089
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001737424005
PA
01
03226101
CAPITAL ADVANTAGE
PA
01
11783712
CAQH
PA
01
1344445
HIGHMARK
PA
01
1548382
GATEWAY
PA
01
203702000
INDEP. BLUE CROSS
PA
01
82873
GEISINGER
PA
01
9908456
AETNA
PA
Enumeration date
10/04/2005
Last updated
03/25/2013
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