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Shane R Wilson-white, NURSEPRACTITIONER
Family Nurse Practitioner in Bloomington, Indiana
NPI 1952910531

Shane R Wilson-white is a Family Nurse Practitioner based in Carbon, IN and is specialized in Family. Shane R Wilson-white practices in Bloomington, IN and has the professional credentials of NURSEPRACTITIONER. The NPI Number for Shane R Wilson-white is 1952910531 and holds a License No. 71010305A (Indiana).

The current practice location address for Shane R Wilson-white is 1004 W 1St St, Bloomington, IN and can be reached out via phone at 812-362-5149.

Location: 1004 W 1St St, Bloomington, IN, 47837-8003
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952910531
Provider Name
Shane R Wilson-white
Credential
NURSEPRACTITIONER
Provider Entity Type
Individual
Gender
Female
Address
1004 W 1St St, Bloomington, IN, 47837-8003
Phone Number
812-362-5149
Fax Number
Provider Enumeration Date
07/29/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1004 W 1St St
City
Bloomington
State
Indiana
Zip
47403-2208
Phone Number
812-362-5149
Fax Number
person
Provider Business Mailing Address Details
Address
1004 W 1St St
City
Bloomington
State
Indiana
Zip
47403-2208
Phone Number
812-362-5149
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
71010305A (Indiana)
Definition
Definition to come...
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