Individual
DANIELLE K WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
15564 WESTCHESTER COMMONS WAY, MIDLOTHIAN, VA 23113-7321
(804) 440-4878
(804) 423-2451
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
(804) 968-1803
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110007882
VA
363A00000X
Physician Assistant
10005132A
IN
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
0110-007882
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300125681
—
IN
Enumeration date
10/31/2019
Last updated
08/06/2026
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