Individual
LANIS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3838 N. RURAL, INDIANAPOLIS, IN 46205-2930
(317) 221-2306
(317) 221-2336
Mailing address
7535 BLUE CREEK S. DR., INDIANAPOLIS, IN 46256
(317) 845-4101
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28143852A
IN
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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