Individual
JENNIFER M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8401 HARCOURT RD, INDIANAPOLIS, IN 46260-2036
(317) 338-4850
Mailing address
8401 HARCOURT RD, INDIANAPOLIS, IN 46260-2036
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01057724A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200822730
—
IN
Enumeration date
06/30/2006
Last updated
04/19/2023
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