IndividualActive
Bernice Wilson
NPI 1649458662 · Specialist · Fort Wayne, IN
Provider details
- NPI number
- 1649458662
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 32001561A (IN)
Specialties & taxonomies
Other Service Providers
Practice location
4202 Buell Dr
Fort Wayne, IN 46807-2743
Phone: (260) 341-4756
Approximate (ZIP-level) locationGet directions
Mailing address
4202 Buell Dr
Fort Wayne, IN 46807-2743
Registry dates
- Enumerated
- 2008-01-31
- Last updated
- 2008-01-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.