Physician Compare National (NPI:1902810906)

HEALTHCARE PROVIDER: PAULA F WILDER FNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1902810906
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668426438
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050318000584
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WILDER
	Individual professional last name
Provider First Name	PAULA
	Individual professional first name
Provider Middle Name	F
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	NP
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BLUFF CITY MULTISPECIALTY CLINIC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9931539038
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	740 BARTLETT RD
	Group Practice or individual's line 1 address
City	MEMPHIS
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	381223004
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9016858202
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y