IndividualActive
Nicole Wilson
NPI 1598214801 · Student in an Organized Health Care Education/Training Program · Ipava, IL
Provider details
- NPI number
- 1598214801
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Student, Health Care
- Athletic Trainer2255A2300X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
81 E Broadway St
Ipava, IL 61441-5236
Phone: (309) 333-4496
Approximate (ZIP-level) locationGet directions
Mailing address
81 E Broadway St
Ipava, IL 61441-5236
Registry dates
- Enumerated
- 2016-09-27
- Last updated
- 2016-09-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.