Individual
AMANDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
740 PINEWOOD DR, BEDFORD, IN 47421-6657
(240) 577-3323
Mailing address
740 PINEWOOD DR, BEDFORD, IN 47421-6657
(240) 577-3323
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
71017345A
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/23/2025
Last updated
11/07/2025
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