Individual
JEANNE WILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
2316 SOUTH STREET, LAFAYETTE, IN 47904-2971
(765) 742-1567
(765) 429-2700
Mailing address
1716 HARTFORD STREET, LAFAYETTE, IN 47904-2138
(765) 742-1567
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004828A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201217180
—
IN
Enumeration date
08/09/2006
Last updated
05/09/2022
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