Healthcare Provider Details

I. General information

NPI: 1578432043
Provider Name (Legal Business Name): LOUISE FRIDAY WILSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W WASHINGTON AVE
MADISON WI
53703-2760
US

IV. Provider business mailing address

201 W WASHINGTON AVE
MADISON WI
53703-2760
US

V. Phone/Fax

Practice location:
  • Phone: 608-266-8857
  • Fax:
Mailing address:
  • Phone: 608-266-8857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number76703-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: