Individual
REBEKAH JOY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6043 HUDSON RD STE 220, WOODBURY, MN 55125-1033
(651) 925-8200
Mailing address
3833 COON RAPIDS BLVD NW, STE 100, COON RAPIDS, MN 55433-2577
(763) 427-8320
(763) 427-1243
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10006
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1045342
PREFERRED ONE
MN
01
—
121502
MEDICA
MN
01
—
135410C029
UCARE
MN
01
—
2378486
AMERICA'S PPO
MN
05
—
42873700
—
WI
05
—
477445100
—
MN
01
—
625T5WI
BCBS OF MN
MN
01
—
HP54882
HEALTHPARTNERS
MN
Enumeration date
07/17/2006
Last updated
08/06/2018
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