MEDICARE: BILLIE J WHEELER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN287355	OH

General Provider Information

NPI Number	:	1285955393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BILLIE J WHEELER RN

Provider Business Mailing Address
First Line	:	2545 BETHESDA AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-1410
Country	:	US
Telephone Number	:	614-257-1242
Fax Number	:

Provider Business Practice Location Address
First Line	:	2545 BETHESDA AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-1410
Country	:	US
Telephone Number	:	614-257-1242
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2010
Last Update Date	:	06/13/2010

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