Individual
MS. LORETTA K WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
900352
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1761X
BCBS
NC
01
—
1861450983
PARTNERS
NC
01
—
268270
MEDCOST
NC
01
—
3648339
UNITED HEALTHCARE
NC
01
—
4744420
AETNA
NC
01
—
P00654521
RAILROAD MEDICARE
NC
01
—
QNP211
SC MEDICAID
SC
Enumeration date
05/01/2006
Last updated
04/04/2014
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