MEDICARE: FELICIA LYNN WILSON

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	3747P1801X	Personal Care Attendant		OH
2	376J00000X	Homemaker		OH

General Provider Information

NPI Number	:	1124843842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA LYNN WILSON

Provider Business Mailing Address
First Line	:	6087 YOSEMITE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-4941
Country	:	US
Telephone Number	:	513-254-9881
Fax Number	:

Provider Business Practice Location Address
First Line	:	1995 WILDOAK CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2967
Country	:	US
Telephone Number	:	513-254-9881
Fax Number	:

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

Provider Enumeration Date	:	11/18/2024
Last Update Date	:	11/18/2024

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