Bernice Wilson is a Specialist based in Fort Wayne, IN. Bernice Wilson practices in Fort Wayne, IN. The NPI Number for Bernice Wilson is 1649458662 and holds a License No. 32001561A (Indiana).
The current practice location address for Bernice Wilson is 4202 Buell Dr, Fort Wayne, IN and can be reached out via phone at 260-341-4756.
Location: 4202 Buell Dr, Fort Wayne, IN, 46807-2743
Provider Profile Details
NPI Number
1649458662
Provider Name
Bernice Wilson
Credential
Provider Entity Type
Individual
Gender
Female
Address
4202 Buell Dr, Fort Wayne, IN, 46807-2743
Phone Number
260-341-4756
Fax Number
Provider Enumeration Date
01/31/2008
Last Update Date
03/09/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32001561A | 01 | IN | COTA |
Provider Business Practice Location Address Details
Address
4202 Buell Dr
City
State
Zip
46807-2743
Phone Number
260-341-4756
Fax Number
Provider Business Mailing Address Details
Address
4202 Buell Dr
City
State
Zip
46807-2743
Phone Number
260-341-4756
Fax Number
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
32001561A (Indiana)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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