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Individual

CAROLE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1130 N BALDWIN AVE, MARION, IN 46952-2536
(765) 660-7480
(765) 382-4495
Mailing address
330 N WABASH, STE G20, MARION, IN 46952-2600
(765) 660-7616
(765) 651-7313

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71001615
IN
363LF0000X
Family Nurse Practitioner
Primary
71001615A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200487860
IN
Enumeration date
08/20/2006
Last updated
01/13/2025
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