Individual
QUIANA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3209 ELMHURST DR, INDIANAPOLIS, IN 46226-6221
(317) 749-4321
Mailing address
3209 ELMHURST DR, INDIANAPOLIS, IN 46226-6221
(317) 749-4321
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
180142201
IN
374U00000X
Home Health Aide
180142201
IN
376J00000X
Homemaker
180142201
IN
376K00000X
Nurse's Aide
180142201
—
385H00000X
Respite Care
180142201
IN
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
180142201
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
821064263
—
IN
Enumeration date
06/26/2020
Last updated
07/01/2020
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