Individual
DEBORAH L WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
305 S 8TH ST STE A, MURRAY, KY 42071-7859
(270) 753-4616
Mailing address
305 S 8TH ST STE A, MURRAY, KY 42071-2404
(270) 753-4616
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3005519
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000569772
ANTHEM ID
KY
01
—
P00630678
RAILROAD MEDICARE ID
KY
Enumeration date
02/28/2008
Last updated
02/28/2023
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