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NPI Code Detail

MEDICARE: SHERI A WILSON PA-C

MEDICARE:   SHERI A WILSON  PA-C
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
1363A00000XPhysician Assistant10000582AIN

General Provider Information

NPI Number : 1568454940
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERI A WILSON PA-C
Provider Business Mailing Address
First Line : 516 WINDY CT
Second Line :
City : KOKOMO
State : IN
Zip : 46901-3703
Country : US
Telephone Number : 269-240-7300
Fax Number :
Provider Business Practice Location Address
First Line : 1245 E IRELAND RD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46614-3448
Country : US
Telephone Number : 743-127-0225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 06/07/2018

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Directions to “ SHERI A WILSON PA-C” Practice Location

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