Wilson, Kim Dittis

Wilson, Kim Dittis is an individual health care provider with primary practice located at 900 E Michigan Ave Ste 105 , Jackson MI 49201-2490. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wilson, Kim Dittis can be contacted via phone (517) 782-3190.

Contact Information

Primary practice address
900 E Michigan Ave Ste 105 Jackson MI 49201-2490
Phone: (517) 782-3190
Fax: (517) 782-1223
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704131316 Michigan

Profile Details

NPI number 1134169311
LBN Legal business name Wilson, Kim Dittis
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Mar 17th, 2018 - about 7 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 1134169311 NPPES
Michigan Other 500017755 RR MEIDCARE

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