Individual
KARMEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1721 MAGNAVOX WAY, FORT WAYNE, IN 46804-1537
(260) 748-3650
Mailing address
1721 MAGNAVOX WAY, FORT WAYNE, IN 46804-1537
(260) 748-3650
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28202168A
IN
363L00000X
Nurse Practitioner
Primary
71009795A
IN
Other
Enumeration date
10/14/2019
Last updated
12/16/2021
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