Individual
NICOLE M WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
429 E VERMONT ST STE 110, INDIANAPOLIS, IN 46202-3685
(317) 559-0950
Mailing address
429 E VERMONT ST STE 110, INDIANAPOLIS, IN 46202-3685
(317) 559-0950
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71016247A
IN
363LP2300X
Primary Care Nurse Practitioner
209.030991
IL
Other
Enumeration date
11/06/2024
Last updated
05/19/2025
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