Wilson, Jodi Anderson

Wilson, Jodi Anderson is an individual health care provider with primary practice located at 55 Lake Ave N Department Of Pulmonary Medicine, Worcester MA 01655. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Wilson, Jodi Anderson can be contacted via phone (508) 856-1975.

Contact Information

Primary practice address
55 Lake Ave N Department Of Pulmonary Medicine Worcester MA 01655
Phone: (508) 856-1975
Fax: (508) 334-7854
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 180210 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X RN180210 Massachusetts

Profile Details

NPI number 1245291251
LBN Legal business name Wilson, Jodi Anderson
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated Oct 31st, 2022 - about 2 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 1245291251 NPPES
Massachusetts MEDICAID 110016488A

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