NPI Code Detail JSON Logo

1134380124 NPI number — CYNTHIA DIANE WILSON PMHCNS-BC

NPI Number: 1134380124
Health Care Provider/Practitioner: CYNTHIA DIANE WILSON PMHCNS-BC

Information about “1134380124” NPI (CYNTHIA DIANE WILSON PMHCNS-BC) exists in 1134380124 in HTML format HTML  |  1134380124 in plain Text format TXT  |  1134380124 in PDF (Portable Document Format) PDF  |  1134380124 in an XML format XML  formats.

NPI Number : 1134380124 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1134380124",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WILSON",
    "FirstName": "CYNTHIA",
    "MiddleName": "DIANE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "PMHCNS-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9615 E 148TH ST STE 1",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NOBLESVILLE",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46060-4371",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "317-587-0517",
    "MailingAddressFaxNumber": "317-674-0060",
    "FirstLinePracticeLocationAddress": "697 PRO MED LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CARMEL",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46032-5323",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "317-574-1254",
    "PracticeLocationAddressFaxNumber": "317-674-0060",
    "EnumerationDate": "06/23/2008",
    "LastUpdateDate": "06/13/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "364SP0809X",
          "TaxonomyName": "Adult Psychiatric/Mental Health Clinical Nurse Specialist",
          "LicenseNumber": "28151446A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "364SP0809X",
          "TaxonomyName": "Adult Psychiatric/Mental Health Clinical Nurse Specialist",
          "LicenseNumber": "70000212A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.