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Individual

SARAH E WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1411 S CREASY LN, SUITE 120, LAFAYETTE, IN 47905-7438
(765) 447-4165
(765) 447-6978
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196

Taxonomy

Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
363AS0400X
Surgical Physician Assistant
Primary
10000906A
IN

Other

Enumeration date
07/26/2006
Last updated
10/15/2009
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