Individual
TERI ANN WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2007
(859) 301-5076
Mailing address
1075 AMBLEWOOD CT, INDEPENDENCE, KY 41051-8209
(859) 301-2007
(859) 301-5076
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1044076
KY
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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