Individual
WADE A NILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
801 5TH ST, SIOUX CITY, IA 51101-1394
(712) 279-2010
Mailing address
1815 AUGUSTA DR, VERMILLION, SD 57069-3462
(605) 624-3729
(605) 677-6569
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001536
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14217
WELLMARK BCBS
—
01
—
25602
MIDLANDS CHOICE
—
05
—
6824154
—
SD
Enumeration date
06/03/2006
Last updated
11/02/2007
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