Individual
MADELEINE R. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4600 VALLEY RD STE 200, LINCOLN, NE 68510-4882
(402) 483-4571
(402) 483-5633
Mailing address
4600 VALLEY RD STE 200, LINCOLN, NE 68510-4882
(402) 483-4571
(402) 483-5633
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
TEP8534
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470553011-00
—
NE
Enumeration date
06/13/2019
Last updated
04/30/2021
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