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NPI Code Detail

MEDICARE: MISS RUBY DIRONDA WILSON RN

MEDICARE: MISS RUBY DIRONDA WILSON RN
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
1163W00000XRegistered NurseR898458MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659758597
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS RUBY DIRONDA WILSON RN
Provider Business Mailing Address
First Line : 3200 W END AVE STE 500
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1322
Country : US
Telephone Number : 615-568-7348
Fax Number :
Provider Business Practice Location Address
First Line : 3200 W END AVE STE 500
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1322
Country : US
Telephone Number : 615-568-7348
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2015
Last Update Date : 12/04/2025

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