Individual
MRS. RUTH ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
207 N TOWNLINE RD STE 201, LAGRANGE, IN 46761-1325
(260) 347-8430
(260) 347-8435
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001034A
IN
363LF0000X
Family Nurse Practitioner
71001034A
IN
Other
Enumeration date
12/21/2006
Last updated
10/17/2022
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