Wilson, Jerald Edwin

Wilson, Jerald Edwin is an individual health care provider with primary practice located at 607 Beaman St , Clinton NC 28328-2603. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Wilson, Jerald Edwin can be contacted via phone (910) 592-8511.

Contact Information

Primary practice address
607 Beaman St Clinton NC 28328-2603
Phone: (910) 592-8511
Fax: (910) 590-8761
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 029672 North Carolina

Profile Details

NPI number 1922146422
LBN Legal business name Wilson, Jerald Edwin
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922146422 NPPES
North Carolina MEDICAID 8050558

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